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1.
J Surg Oncol ; 124(6): 967-976, 2021 Nov.
Article in English | MEDLINE | ID: mdl-34599762

ABSTRACT

This review explores how human papillomavirus-related oropharyngeal cancer affects health-related quality of life (HR-QoL) and the role patient-reported outcomes (PROs) can play in optimizing treatment. PRO measures (PROMs) are comprehensive, subjective assessments of patients' day-to-day HR-QoL. Developed through a scientifically robust, multistage process, PROMs offer insight into patients' symptoms, function, and satisfaction with care. The use of PROMs can increase symptom awareness, stimulate discussion, and enhance shared decision-making between patients and healthcare providers.


Subject(s)
Oropharyngeal Neoplasms/therapy , Oropharyngeal Neoplasms/virology , Papillomaviridae/isolation & purification , Papillomavirus Infections/pathology , Clinical Trials, Phase II as Topic , Clinical Trials, Phase III as Topic , Humans , Oropharyngeal Neoplasms/pathology , Papillomavirus Infections/virology , Patient Reported Outcome Measures , Quality of Life , Randomized Controlled Trials as Topic
2.
J Surg Oncol ; 124(5): 731-739, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34236707

ABSTRACT

OBJECTIVES: Sinonasal and skull base tumors are rare, making it difficult to identify trends in surgical outcome. This study examines complications in a large cohort of patients undergoing surgery for sinonasal malignancy. METHODS: Following IRB approval, an institutional database was reviewed to identify patients who underwent surgery for sinonasal or skull base malignancies from 1973 to 2016 at our institution. Charlson comorbidity index score and Clavien-Dindo grade were calculated. The main study endpoint was subgroup analysis of Clavien-Dindo Grade 0, Grades 1-2, and Grades 3-5 complications. An ordinal logistic regression model was constructed to assess the association between comorbidities, demographics, tumor characteristics, and surgical complications. RESULTS: In total, 448 patients met inclusion criteria. Perioperative mortality rate at 30 days was 1.6% (n = 7). The rate of severe complications (Clavien-Dindo 3 or higher) was 13.6% (n = 61). Multivariate analysis using an ordinal logistic regression model showed no association between Charlson comorbidity index score and Clavien-Dindo grade of postoperative complication. Advanced T-stage was significantly associated with complications (p = 0.0014; odds ratio: 3.442 [95% confidence interval: 1.615, 7.338]). CONCLUSION: Surgery for sinonasal and skull base tumors is safe with a low mortality rate. Advanced T-stage is associated with postoperative complications. These findings have implications for preoperative risk stratification. Key Points Surgery for sinonasal malignancy is safe with a 30 mortality of 1.6% and rate of severe complications of 12.8%. There is no association between patient comorbidity and post operative complication. On multivariate analysis, only advanced T stage was associated with increased rate of surgical complication.


Subject(s)
Nose Neoplasms/surgery , Paranasal Sinus Neoplasms/surgery , Postoperative Complications/pathology , Skull Base Neoplasms/surgery , Surgical Procedures, Operative/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Middle Aged , Nose Neoplasms/pathology , Paranasal Sinus Neoplasms/pathology , Postoperative Complications/etiology , Prognosis , Prospective Studies , Retrospective Studies , Skull Base Neoplasms/pathology , Survival Rate , Young Adult
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