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

Roy Xiao; Rohan R. Joshi; Qasim Husain; Jennifer R. Cracchiolo; Nancy Lee; Jillian Tsai; Yao Yu; Linda Chen; Jung J. Kang; Sean McBride; Nadeem Riaz; Benjamin R. Roman; Ian Ganly; Viviane Tabar; Stacey T. Gray; Marc A. Cohen

doi:10.1002/hed.25873

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

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

Otolaryngology

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

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.

Original language	English (US)
Pages (from-to)	3551-3563
Number of pages	13
Journal	Head and Neck
Volume	41
Issue number	10
DOIs	https://doi.org/10.1002/hed.25873
State	Published - Oct 1 2019

Keywords

National Cancer Database
overall survival
postoperative time to radiation therapy
sinonasal squamous cell carcinoma
time to surgery

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.25873

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Xiao, R., Joshi, R. R., Husain, Q., Cracchiolo, J. R., Lee, N., Tsai, J., Yu, Y., Chen, L., Kang, J. J., McBride, S., Riaz, N., Roman, B. R., Ganly, I., Tabar, V., Gray, S. T., & Cohen, M. A. (2019). Timing of surgery and adjuvant radiation therapy for sinonasal malignancies: Effect of surgical approach. Head and Neck, 41(10), 3551-3563. https://doi.org/10.1002/hed.25873

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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",

author = "Roy Xiao and Joshi, {Rohan R.} and Qasim Husain and Cracchiolo, {Jennifer R.} and Nancy Lee and Jillian Tsai and Yao Yu and Linda Chen and Kang, {Jung J.} and Sean McBride and Nadeem Riaz and Roman, {Benjamin R.} and Ian Ganly and Viviane Tabar and Gray, {Stacey T.} and Cohen, {Marc A.}",

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doi = "10.1002/hed.25873",

language = "English (US)",

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T1 - Timing of surgery and adjuvant radiation therapy for sinonasal malignancies

T2 - Effect of surgical approach

AU - Xiao, Roy

AU - Joshi, Rohan R.

AU - Husain, Qasim

AU - Cracchiolo, Jennifer R.

AU - Lee, Nancy

AU - Tsai, Jillian

AU - Yu, Yao

AU - Chen, Linda

AU - Kang, Jung J.

AU - McBride, Sean

AU - Riaz, Nadeem

AU - Roman, Benjamin R.

AU - Ganly, Ian

AU - Tabar, Viviane

AU - Gray, Stacey T.

AU - Cohen, Marc A.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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.

KW - National Cancer Database

KW - overall survival

KW - postoperative time to radiation therapy

KW - sinonasal squamous cell carcinoma

KW - time to surgery

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

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