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Surgical approach is associated with complication rate in sinonasal malignancy: A multicenter study
Daniel M Beswick1, Peter H Hwang2, Nithin D Adappa3
1Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, CA.
International Forum of Allergy & Rhinology
|June 27, 2021
Summary
Open/combined resection for sinonasal malignancy is linked to higher complication risks. This study highlights the need for further research into surgical approaches and patient outcomes in sinonasal cancer treatment.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Sinonasal malignancy (SNM) management frequently involves surgical resection.
- Surgical complications (morbidity) are a concern, but risk factors are understudied.
Purpose of the Study:
- Investigate risk factors for surgical complications in SNM patients.
- Compare complication rates between endoscopic and open/combined resection approaches.
Main Methods:
- Prospective, multi-institutional cohort study of 142 adult SNM patients (2015-2020).
- Data collected on demographics, disease, and treatment.
- Complications assessed included CSF leak, orbital/intracranial injury, diplopia, meningitis, osteoradionecrosis, neutropenia hospitalization, and chronic rhinosinusitis.
- Surgical approaches: endoscopic resection (ER) vs. open/combined resection (O/CR).
- Statistical analysis: t-test, Fisher's exact test, logistic regression.
Main Results:
- Overall complication rate was 16.2% (23/142 patients).
- Adjuvant radiation therapy was associated with increased complications (unadjusted analysis).
- Open/combined resection (O/CR) group had higher T-stage, more adjuvant radiation, and chemotherapy.
- Regression analysis indicated O/CR was associated with increased odds of complications (OR, 3.34; 95% CI, 1.06-11.19), even after accounting for radiation therapy.
Conclusions:
- Prospective, multicenter evaluation of SNM treatment is feasible.
- Open/combined resection is associated with a higher risk of complications.
- Further research is needed to validate these findings and inform treatment strategies.
