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Comparative Study
. 2019 Oct;41(10):3551-3563.
doi: 10.1002/hed.25873. Epub 2019 Jul 11.

Timing of surgery and adjuvant radiation therapy for sinonasal malignancies: Effect of surgical approach

Roy Xiao  1 , Rohan R Joshi  2 , Qasim Husain  1 , Jennifer R Cracchiolo  3 , Nancy Lee  4 , Jillian Tsai  4 , Yao Yu  4 , Linda Chen  4 , Jung J Kang  4 , Sean McBride  4 , Nadeem Riaz  4 , Benjamin R Roman  3 , Ian Ganly  3 , Viviane Tabar  5 , Stacey T Gray  1 , Marc A Cohen  3
Affiliations
Comparative Study

Timing of surgery and adjuvant radiation therapy for sinonasal malignancies: Effect of surgical approach

Roy Xiao et al. Head Neck. 2019 Oct.

Abstract

Background: Timely postoperative radiation therapy (RT) within 50 days of surgery for head and neck cancers provides a survival advantage.

Methods: Using the National Cancer Database, we performed a propensity score-matched analysis comparing patients undergoing open or endoscopic surgery for squamous cell carcinoma (SCC) of the nasal cavity and paranasal sinuses from 2010 to 2015.

Results: Among 168 pairs, patients undergoing endoscopic surgery had shorter time to surgery (24.2 vs 36.7 days, P < .001) and shorter postoperative time to RT (PTTR, 51.2 vs 58.4 days, P = .02). On multivariable linear regression, endoscopic surgery predicted shorter PTTR (β = -7.6, P = .01). Using the Kaplan-Meier method, patients in the longest PTTR quartile had decreased overall survival (OS; Q1 vs Q4, 3-year OS 76.5% vs 53.3%, P = .007), a durable finding when adjusted for covariates (Q1 vs Q4, HR 0.50, P = .008).

Conclusions: Patients undergoing endoscopic surgery for sinonasal SCC experience shorter PTTR. Shorter PTTR is associated with extended OS.

Keywords: National Cancer Database; overall survival; postoperative time to radiation therapy; sinonasal squamous cell carcinoma; time to surgery.

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Conflict of interest statement

Financial Disclosures, Conflicts of Interest: This research was funded in part the NIH/NCI Cancer Center Support Grant, P30CA008748.

Figures

Figure 1.
Figure 1.. Consolidated Standards of Reporting Trials Diagram Detailing the Study Inclusion Criteria
NCDB, National Cancer Database; N, number; cT, tumor classification; cN, node classification; cM, metastasis classification; cM1, positive metastasis classification
Figure 2.
Figure 2.. Kaplan-Meier Curves Estimating Times to Events
Kaplan-Meier estimates of time to events subset by surgical approach. (A) Median time to surgery did not have a statistically significant association between endoscopic surgery and open surgery (16.5 vs. 29.0 days, p<0.001). (B-D) Median time to discharge (1.0 vs. 3.0 days, p<0.001), median time to RT (69.5 vs. 85.0 days, p<0.001), and median postoperative time to RT (46.0 vs. 51.5 days, p=0.010) were all significantly shorter for patients undergoing endoscopic surgery compared to those undergoing open surgery.
Figure 3.
Figure 3.. Kaplan-Meier Curves Estimating Overall Survival
Kaplan-Meier estimates of overall survival. (A) Overall survival for the complete cohort had a 68.2% 3-year OS. (B) Overall survival subset by postoperative time to RT relative to the median (49 days) revealed significantly longer survival for patients waiting less than the median compared to those waiting at least the median (3-year OS 74.2% vs. 61.4%, p=0.043). Overall survival subset by quartile of postoperative time to RT revealed no significant differences in OS between the first three quartiles (3-year OS 76.5% vs. 72.0% vs. 70.5%), but significantly shortened OS for the quartile with the longest wait (3-year OS 53.3%, p=0.007).
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References

    1. Osguthorpe JD, Richardson M. Frontal sinus malignancies. Otolaryngol Clin North Am. 2001;34(1):269–281. - PubMed
    1. Kilic S, Shukla PA, Marchiano EJ, et al. Malignant Primary Neoplasms of the Nasal Cavity and Paranasal Sinus. Curr Otorhinolaryngol Rep. 2016;4(4):249–258.
    1. Kilic S, Kilic SS, Baredes S, Liu JK, Eloy JA. Survival, Morbidity, and Quality-of-Life Outcomes for Sinonasal and Ventral Skull Base Malignancies. Otolaryngol Clin North Am. 2017;50(2):467–480. - PubMed
    1. Lee CH, Hur DG, Roh H-J, et al. Survival rates of sinonasal squamous cell carcinoma with the new AJCC staging system. Arch Otolaryngol Head Neck Surg. 2007;133(2):131–134. - PubMed
    1. Ansa B, Goodman M, Ward K, et al. Paranasal sinus squamous cell carcinoma incidence and survival based on Surveillance, Epidemiology, and End Results data, 1973 to 2009. Cancer. 2013;119(14):2602–2610. - PubMed

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