预测鼻窦恶性肿瘤患者基线生活质量下降的相关因素。
Predictive factors for decreased baseline quality of life in patients with sinonasal malignancies.
发表日期：2023 Aug 30
作者：
Cara M Fleseriu, Daniel M Beswick, Sabrina L Maoz, Peter H Hwang, Garret Choby, Edward C Kuan, Erik P Chan, Nithin D Adappa, Mathew Geltzeiler, Anne E Getz, Ian M Humphries, Christopher H Le, Waleed M Abuzeid, Eugene H Chang, Aria Jafari, Todd T Kingdom, Michael A Kohanski, Jivianne K Lee, Seyed A Nabavizadeh, Jayakar V Nayak, James N Palmer, Zara M Patel, Carlos D Pinheiro-Neto, Adam C Resnick, Timothy L Smith, Carl H Snyderman, Maie A St John, Jay Storm, Jeffrey D Suh, Marilene B Wang, Eric W Wang
来源：
BIOMEDICINE & PHARMACOTHERAPY
摘要：
对于副鼻窦恶性肿瘤（SNMs）对生活质量（QOL）的影响在初次发现时了解很少。副鼻窦结果测试（SNOT-22）和华盛顿大学生活质量量表（UWQOL）是经过验证的生活质量仪器，具有独特的子领域。该研究旨在确定影响SNM患者治疗前生活质量因素，以个性化多学科管理和咨询。既往未经治疗的SNM患者被纳入多中心观察性研究中（2015-2022）。获得基线治疗前生活质量仪器（SNOT-22，UWQOL），以及人口统计学、共病疾病、组织病理学/分期、肿瘤侵犯和症状。多变量回归模型确定与基线生活质量降低相关的因素。在204位患者中，基线生活质量呈显著降低。多变量回归表明，颅底骨腐蚀的患者总共SNOT-22生活质量更差（p = 0.02）。妇女（p = 0.009），流鼻血（p = 0.036）和工业暴露（p = 0.005）的患者的SNOT鼻病学生活质量更差。工业暴露的患者的SNOT非鼻孔生活质量更差（p = 0.016）；PNI的患者有更差的SNOT耳/面生活质量（p = 0.027）。鳞状细胞癌病理学（p = 0.037），腭受累（p = 0.012），疼痛（p = 0.017）与更差的SNOT睡眠生活质量得分相关。具有腭病变（p = 0.022），颅底骨腐蚀（p = 0.025）和T1分期（p = 0.023）的患者的SNOT心理子领域得分更差。在UW健康方面，PNI的存在更容易导致低生活质量（p = 0.019），而在UW总体方面，眼眶骨腐蚀更容易导致低生活质量（p = 0.03）。如果有腭受累（p = 0.023）或PNI（p = 0.005），UW社交生活质量更差。我们的研究结果表明，SNM患者的基线生活质量受到负面影响，并提示与性别特异性和症状相关的较低生活质量得分，与组织病理学的关联较小。解剖学上的肿瘤侵犯可能更能反映生活质量，因为眼眶和颅底骨腐蚀，PNI和腭病变与基线生活质量降低显著相关。© 2023 ARS-AAOA, LLC.
The impact of sinonasal malignancies (SNMs) on quality of life (QOL) at presentation is poorly understood. The Sinonasal Outcome Test (SNOT-22) and University of Washington Quality of Life (UWQOL) are validated QOL instruments with distinctive subdomains. This study aims to identify factors impacting pretreatment QOL in SNM patients to personalize multidisciplinary management and counseling.Patients with previously untreated SNMs were prospectively enrolled (2015-2022) in a multicenter observational study. Baseline pretreatment QOL instruments (SNOT-22, UWQOL) were obtained along with demographics, comorbidities, histopathology/staging, tumor involvement, and symptoms. Multivariable regression models identified factors associated with reduced baseline QOL.Among 204 patients, presenting baseline QOL was significantly reduced. Multivariable regression showed worse total SNOT-22 QOL in patients with skull base erosion (p = 0.02). SNOT-rhinologic QOL was worse in women (p = 0.009), patients with epistaxis (p = 0.036), and industrial exposure (p = 0.005). SNOT extranasal QOL was worse in patients with industrial exposure (p = 0.016); worse SNOT ear/facial QOL if perineural invasion (PNI) (p = 0.027). Squamous cell carcinoma pathology (p = 0.037), palate involvement (p = 0.012), and pain (p = 0.017) were associated with worse SNOT sleep QOL scores. SNOT psychological subdomain scores were significantly worse in patients with palate lesions (p = 0.022), skull base erosion (p = 0.025), and T1 staging (p = 0.023). Low QOL was more likely in the presence of PNI on UW health (p = 0.019) and orbital erosion on UW overall (p = 0.03). UW social QOL was worse if palatal involvement (p = 0.023) or PNI (p = 0.005).Our findings demonstrate a negative impact on baseline QOL in patients with SNMs and suggest sex-specific and symptom-related lower QOL scores, with minimal histopathology association. Anatomical tumor involvement may be more reflective of QOL than T-staging, as orbital and skull base erosion, PNI, and palate lesions are significantly associated with reduced baseline QOL.© 2023 ARS-AAOA, LLC.