University of Washington Quality of Life subdomain outcomes after treatment of sinonasal malignancy: A prospective, multicenter study.
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Maoz Sabrina L, Golzar Autreen, Choby Garret, Hwang Peter H, Wang Eric W, Kuan Edward C, Adappa Nithin D, Geltzeiler Mathew, Getz Anne E, Humphreys Ian M, Le Christopher H, Pinheiro-Neto Carlos D, Fischer Jakob L, Chan Erik P, Abuzeid Waleed M, Chang Eugene H, Jafari Aria, Kingdom Todd T, Kohanski Michael A, Lee Jivianne K, Lazor Jillian W, Nabavizadeh Ali, Nayak Jayakar V, Palmer James N, Patel Zara M, Resnick Adam C, Smith Timothy L, Snyderman Carl H, St John Maie A, Storm Phillip B, Suh Jeffrey D, Wang Marilene B, Sim Myung S, Beswick Daniel M
Аннотация
METHODS: In this prospective, multi-institutional study, 273 patients with SNMs who underwent definitive treatment with curative intent were evaluated. We used the University of Washington Quality of Life (UWQOL) instrument over 5 years from diagnosis to identify demographic, treatment, and disease-related factors that influence each of the 12 UWQOL subdomains from baseline to 5 -years post-treatment.
RESULTS: Multivariate models found endoscopic resection predicted improved pain (vs. nonsurgical treatment CI 2.4, 19.4, p = 0.01) and appearance versus open (CI 27.0, 35.0, p < 0.001) or combined (CI 10.4, 17.1, p < 0.001). Pterygopalatine fossa involvement predicted worse swallow (CI -10.8, -2.4, p = 0.01) and pain (CI -17.0, -4.0, p < 0.001). Neck dissection predicted worse swallow (CI -14.8, -2.8, p < 0.001), taste (CI -31.7, -1.5, p = 0.02), and salivary symptoms (CI -28.4, -8.6, p < 0.001). Maxillary involvement predicted worse chewing (CI 9.8, 33.2; p < 0.001) and speech (CI -21.8, -5.4, p < 0.001) relative to other sites. Advanced T stage predicted worse anxiety (CI -13.0, -2.0, p = 0.03).
CONCLUSIONS: Surgical approach, management of cervical disease, tumor extent, and site of involvement impacted variable UWQOL symptom areas. Endoscopic resection predicted better pain, appearance, and chewing compared with open. These results may aid in counseling patients regarding potential QOL expectations in their SNM treatment and recovery course.