Abstract：
BACKGROUND: Patients with sinonasal malignancy (SNM) present with significant sinonasal quality of life (QOL) impairment. Global sinonasal QOL as measured by the 22-item Sinonasal Outcomes Test (SNOT-22) has been shown to improve with treatment. This study aims to characterize SNOT-22 subdomain outcomes in SNM.
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.
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.
摘要：
背景：患有鼻窦恶性肿瘤（SNM）的患者存在明显的鼻窦生活质量（QOL）损害。通过22项鼻窦结果测试（SNOT-22）测量的全球鼻窦QOL已显示出随着治疗而改善。本研究旨在表征SNM中的SNOT-22子域结果。
方法：将诊断为SNM的患者前瞻性纳入多中心患者登记。在诊断时和治疗后的长达5年的时间内收集SNOT-22评分。多变量回归分析用于确定SNOT-22子域变异的驱动因素。
结果：请注意，对234例患者进行了回顾，平均随访22个月（3个月-64个月）。鼻科,心理,与基线相比，睡眠亚域显着改善（所有p<0.05）。在所有时间点进行随访的40例患者的亚分析显示，鼻科有统计学意义的改善，鼻外,心理,和睡眠子域，在睡眠和心理亚域中，2至5年之间的临床重要差异最小。辅助放化疗与鼻科预后较差相关（校正比值比（5.22[1.69-8.66]）），鼻外（2.21[0.22-4.17]）和耳/面部（5.53[2.10-8.91]）亚结构域。翼腭窝受累与鼻（3.22[0.54-5.93]）和耳/面部（2.97[0.32-5.65]）子域的不良预后相关。阳性切缘（5.74[2.17-9.29]）和联合手术方法与内镜（3.41[0.78-6.05]）与较差的心理结局相关。辅助辐射（2.28[0.18-4.40]）与较差的睡眠结果相关。
结论：与SNM治疗相关的鼻窦QOL改善是由鼻窦，鼻外,心理,和睡眠子域。
方法：将诊断为SNM的患者前瞻性纳入多中心患者登记。在诊断时和治疗后的长达5年的时间内收集SNOT-22评分。多变量回归分析用于确定SNOT-22子域变异的驱动因素。
结果：请注意，对234例患者进行了回顾，平均随访22个月（3个月-64个月）。鼻科,心理,与基线相比，睡眠亚域显着改善（所有p<0.05）。在所有时间点进行随访的40例患者的亚分析显示，鼻科有统计学意义的改善，鼻外,心理,和睡眠子域，在睡眠和心理亚域中，2至5年之间的临床重要差异最小。辅助放化疗与鼻科预后较差相关（校正比值比（5.22[1.69-8.66]）），鼻外（2.21[0.22-4.17]）和耳/面部（5.53[2.10-8.91]）亚结构域。翼腭窝受累与鼻（3.22[0.54-5.93]）和耳/面部（2.97[0.32-5.65]）子域的不良预后相关。阳性切缘（5.74[2.17-9.29]）和联合手术方法与内镜（3.41[0.78-6.05]）与较差的心理结局相关。辅助辐射（2.28[0.18-4.40]）与较差的睡眠结果相关。
结论：与SNM治疗相关的鼻窦QOL改善是由鼻窦，鼻外,心理,和睡眠子域。
