SNOT-22 subdomain outcomes following treatment for sinonasal malignancy: A prospective, multicenter study.
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Grimm David R, Beswick Daniel M, Maoz Sabrina L, Wang Eric W, Choby Garret W, Kuan Edward C, Chan Erik P, Adappa Nithin D, Geltzeiler Mathew, Getz Anne E, Humphreys Ian M, Le Christopher H, Abuzeid Waleed M, Chang Eugene H, Jafari Aria, Kingdom Todd T, Kohanski Michael A, Lee Jivianne K, Nayak Jayakar V, Palmer James N, Patel Zara M, Pinheiro-Neto Carlos D, Resnick Adam C, Sim Myung S, Smith Timothy L, Snyderman Carl H, John Maie A, Storm Phillip, Suh Jeffrey D, Wang Marilene B, Hwang Peter H
Аннотация
METHODS: Patients diagnosed with SNM were prospectively enrolled in a multi-center patient registry. SNOT-22 scores were collected at the time of diagnosis and through the post-treatment period for up to 5 years. Multivariable regression analysis was used to identify drivers of variation in SNOT-22 subdomains.
RESULTS: Note that 234 patients were reviewed, with a mean follow-up of 22 months (3 months-64 months). Rhinologic, psychological, and sleep subdomains significantly improved versus baseline (all p < 0.05). Subanalysis of 40 patients with follow-up at all timepoints showed statistically significant improvement in rhinologic, extra-nasal, psychological, and sleep subdomains, with minimal clinically important difference met between 2 and 5 years in sleep and psychological subdomains. Adjuvant chemoradiation was associated with worse outcomes in rhinologic (adjusted odds ratio (5.22 [1.69-8.66])), extra-nasal (2.21 [0.22-4.17]) and ear/facial (5.53 [2.10-8.91]) subdomains. Pterygopalatine fossa involvement was associated with worse outcomes in rhinologic (3.22 [0.54-5.93]) and ear/facial (2.97 [0.32-5.65]) subdomains. Positive margins (5.74 [2.17-9.29]) and surgical approach-combined versus endoscopic (3.41 [0.78-6.05])-were associated with worse psychological outcomes. Adjuvant radiation (2.28 [0.18-4.40]) was associated with worse sleep outcomes.
CONCLUSIONS: Sinonasal QOL improvements associated with treatment of SNM are driven by rhinologic, extra-nasal, psychological, and sleep subdomains.