J Neurol Surg B 2019; 80(04): 371-379
DOI: 10.1055/s-0038-1675233
Original Article
Georg Thieme Verlag KG Stuttgart · New York

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

Qasim Husain
1  Department of Otolaryngology – Head and Neck Surgery, Columbia University Medical Center, New York, New York, United States
2  Department of Otolaryngology – Head and Neck Surgery, Weill Cornell Medical College, New York, New York, United States
,
Rohan R. Joshi
1  Department of Otolaryngology – Head and Neck Surgery, Columbia University Medical Center, New York, New York, United States
2  Department of Otolaryngology – Head and Neck Surgery, Weill Cornell Medical College, New York, New York, United States
,
Jennifer R. Cracchiolo
3  Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Benjamin R. Roman
3  Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Ian Ganly
3  Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Viviane Tabar
4  Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Marc A. Cohen
3  Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, United States
› Author Affiliations
Further Information

Publication History

28 May 2018

29 August 2018

Publication Date:
25 October 2018 (eFirst)

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.

Note

Presented at 2018 North American Skull Base Meeting Coronado, California.


All authors have approved the final manuscript and attest to the integrity of the original data and the analysis reported in the manuscript.


Financial Disclosures

This research was supported by a National Institute of Health/ National Cancer Institute Cancer Center Support Grant, Grant number: P30 CA008748