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Association of multidisciplinary team management with survival in sinonasal malignancies: a real-world IPTW cohort
Huanhuan Lyu1,2, Hang Li1,2, Rui He1,2
1Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, No 58, Zhong Shan 2nd Road, Guangzhou, 510080, Guangdong, PR China.
Purpose:
Sinonasal malignancies (SNMs) are rare, heterogeneous, and aggressive. High-quality evidence to guide management is limited, and the prognostic value of multidisciplinary team (MDT) management remains incompletely characterized. This study aims at evaluating the association of MDT management with survival outcomes and treatment selection among patients with SNMs.
Methods:
Retrospective cohort study including 304 consecutive patients with histologically confirmed SNMs treated at the First Affiliated Hospital of Sun Yat-sen University between September 2017 and December 2023. Patients were classified according to whether their cases underwent a formal MDT review process before the definitive treatment plan was initiated. The primary outcome was overall survival (OS). Baseline differences were addressed using stabilized inverse probability of treatment weighting (IPTW). Survival was analyzed with Kaplan-Meier estimates and weighted Cox proportional hazards models. Treatment patterns were compared using weighted logistic regression. Secondary outcomes included length of hospital stay and hospitalization costs.
Results:
Of 304 included patients, 106 (34.9%) received MDT management. After weighting, 3-year and 5-year OS rates were 85.9% and 75.8% with MDT versus 74.8% and 63.3% without MDT (P = 0.034 and 0.125 respectively). MDT management was associated with longer OS (hazard ratio, 0.52; 95% CI, 0.30-0.91; P = 0.020). Subgroup analyses suggested consistent associations across all predefined subgroups. MDT involvement was also associated with shorter hospital stay without increased hospitalization costs.
Conclusions:
In this single-center cohort, MDT management was associated with optimized treatment selection and improved overall survival in patients with SNMs, with consistent effects across clinical subgroups. Establishing efficient, standardized MDT workflows may help improve outcomes for sinonasal and skull base malignancies; prospective multicenter studies are warranted to validate these associations.