Analysis of Staging, Treatment, and Time to Treatment of Adult Sinonasal Cancer: A Trinetx Database Study

Introduction: Sinonasal malignancies represent a rare group of tumors without well-understood data to guide treatment decisions. Many sinonasal cancers are diagnosed at an advanced stage, as they are asymptomatic until they become large enough to cause obstructive symptoms. Delays in initiating treatment can negatively impact disease control and survival. This study aims to characterize treatment pathways and time to treatment in early and late-stage sinonasal cancers among a large database cohort of adult patients.

Methods: We conducted a retrospective analysis using the TriNetX Research Network database. Patients 18 years and older who underwent surgical resection of a sinonasal tumor were identified by ICD 10 and CPT codes (C30 and C31). We assessed patient demographics, associated symptoms and disease complications, treatment modalities, and time from diagnosis to various treatment modalities among the patient cohort.

Results: This study consisted of 858 patients with sinonasal cancer. These patients presented with generalized symptoms (16%) such as headache, fever, fatigue, and sometimes more specific symptoms such as localized swelling (17%), abnormalities of breathing (3%) and epistaxis (6%). When further stratifying for staging, 227 patients had early-stage (stages 1 and 2), and 631 had late-stage malignancies (stages 3 and 4). For early-stage cancers, surgery was the most common first-line treatment (65.1%), followed by radiation (24.2%), chemotherapy (7.38%), and combined chemoradiation (3.36%). The median time from diagnosis to surgery was 33 days, and diagnosis to radiation was 73 days. Similarly, concerning the 631 patients with late-stage cancer, surgery was the most common treatment, followed by radiation, chemotherapy, or combined chemoradiation (46.8, 26.3, 24.5, 2.97%, respectively). The median time from diagnosis to surgery was 22 days, and 54 days from diagnosis to radiation.

Conclusion: It is crucial to understand the treatment modalities utilized based on stage of the disease to guide shared decision-making in the treatment of sinonasal cancers. Among our patient cohort, there was a greater delay to treatment in early-stage disease compared with late-stage disease. These variations in time to treatment across different stages warrant further investigation.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
15 February 2022