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

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


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 languageEnglish (US)
Pages (from-to)3551-3563
Number of pages13
JournalHead and Neck
Issue number10
StatePublished - Oct 1 2019


  • 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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