Impact of palliative treatment on survival in sinonasal malignancies

Abstract

BACKGROUND: Although palliative care treatment modalities have been shown to improve functional outcomes and provide symptom alleviation in sinonasal cancer, its impact on survival still remains unclear. In this study we aimed to elicit the impact of different palliative therapy options on survival in a nationally representative sample of sinonasal cancer patients. METHODS: National Cancer Database 2004-2015 data sets were queried for cases of primary sinonasal cancer (N = 380). Kaplan-Meier analysis was utilized to determine median overall survival (M-OS) and overall survival (OS) among the different treatment cohorts (pain management, palliative radiation therapy, palliative chemotherapy, palliative surgery, and combination therapy). Prognostic factors were elicited by comparing OS by log-rank tests and subsequent multivariate Cox regression analysis. RESULTS: Of the total patients of sinonasal malignancy treated with palliative therapy, most were <70 years old, had stage 4 cancer, and histology indicating squamous cell carcinoma (p < 0.05). On Kaplan-Meier survival analysis, the 1-year OS (1Y-OS) and M-OS were 43.6% and 10.1 months, respectively. The 1Y-OS and M-OS for pain management alone were 35.3% and 4.56 months, respectively. Surgery had the highest 1Y-OS and M-OS, at 74.7% and 22.8 months, respectively (p = 0.002). All treatment modalities had increased 1Y-OS compared with pain management alone. Multivariant analysis demonstrated palliative surgery to be associated with decreased risk of death (hazard ratio, 0.33; 95% confidence interval, 0.17-0.63). CONCLUSION: In this study we identify the impact of palliative treatment modalities on survival in sinonasal cancer. Palliative surgery was shown to have the highest 1Y-OS and M-OS compared with other palliative treatment modalities.