Surgical Management Patterns of Sinonasal Malignancy: A Population-Based Study

Qasim Husain, Rohan Joshi, Jennifer R. Cracchiolo, Benjamin R. Roman, Ian Ganly, Viviane Tabar, Marc A. Cohen

Research output: Contribution to journalArticle

Abstract

Objectives ?Determining surgical trends and outcomes for sinonasal tumors is challenging given their low incidence and heterogeneous pathology. This study utilized the National Cancer Database (NCDB) to identify trends and outcomes associated with surgical management of sinonasal tumors. Design ?Retrospective database analysis. Setting ?National Cancer Database. Participants ?Patients with sinonasal malignancies identified from the NCDB between 2010 and 2015. Main Outcome Measures ?The primary outcome was the choice of surgical therapy used for sinonasal tumor resection: endoscopic versus open approach. Each was cohort analyzed with respect to various demographic and clinicopathologic factors. A treatment effect model was used to identify potential differences between surgical approaches. Survival was evaluated using Kaplan-Meier analysis. Results ?A total of 10,193 patients with sinonasal malignancies were identified in the NCDB database; of these, 2,292 had a documented subsite, histology, and definitive surgical treatment with documented surgical approach and were included in the analysis. About 71.9% of patients had an open approach and 28.1% a purely endoscopic procedures. Tumor histology, treatment facility type, margin status, and length of stay were all variables that were associated with significant differences between the open and endoscopic cohort. Five-year survival rates for the open and endoscopic cohorts were not significantly different (59.6 and 60.8%, respectively). Conclusions ?Assessment of the NCDB revealed that 28% patients with sinonasal malignancy were selected for endoscopic surgery. These patients had comparable oncologic outcomes to open resection.

Original languageEnglish (US)
Pages (from-to)371-379
Number of pages9
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume80
Issue number4
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Population
Neoplasms
Databases
Histology
Kaplan-Meier Estimate
Therapeutics
Length of Stay
Survival Rate
Demography
Outcome Assessment (Health Care)
Pathology
Survival
Incidence

Keywords

  • NCDB
  • population-based
  • sinonasal malignancies
  • sinonasal tumor

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Surgical Management Patterns of Sinonasal Malignancy : A Population-Based Study. / Husain, Qasim; Joshi, Rohan; Cracchiolo, Jennifer R.; Roman, Benjamin R.; Ganly, Ian; Tabar, Viviane; Cohen, Marc A.

In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 80, No. 4, 01.01.2019, p. 371-379.

Research output: Contribution to journalArticle

Husain, Qasim ; Joshi, Rohan ; Cracchiolo, Jennifer R. ; Roman, Benjamin R. ; Ganly, Ian ; Tabar, Viviane ; Cohen, Marc A. / Surgical Management Patterns of Sinonasal Malignancy : A Population-Based Study. In: Journal of Neurological Surgery, Part B: Skull Base. 2019 ; Vol. 80, No. 4. pp. 371-379.
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abstract = "Objectives ?Determining surgical trends and outcomes for sinonasal tumors is challenging given their low incidence and heterogeneous pathology. This study utilized the National Cancer Database (NCDB) to identify trends and outcomes associated with surgical management of sinonasal tumors. Design ?Retrospective database analysis. Setting ?National Cancer Database. Participants ?Patients with sinonasal malignancies identified from the NCDB between 2010 and 2015. Main Outcome Measures ?The primary outcome was the choice of surgical therapy used for sinonasal tumor resection: endoscopic versus open approach. Each was cohort analyzed with respect to various demographic and clinicopathologic factors. A treatment effect model was used to identify potential differences between surgical approaches. Survival was evaluated using Kaplan-Meier analysis. Results ?A total of 10,193 patients with sinonasal malignancies were identified in the NCDB database; of these, 2,292 had a documented subsite, histology, and definitive surgical treatment with documented surgical approach and were included in the analysis. About 71.9{\%} of patients had an open approach and 28.1{\%} a purely endoscopic procedures. Tumor histology, treatment facility type, margin status, and length of stay were all variables that were associated with significant differences between the open and endoscopic cohort. Five-year survival rates for the open and endoscopic cohorts were not significantly different (59.6 and 60.8{\%}, respectively). Conclusions ?Assessment of the NCDB revealed that 28{\%} patients with sinonasal malignancy were selected for endoscopic surgery. These patients had comparable oncologic outcomes to open resection.",
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