2025 Poster Presentations
P319: DELAY IN TREATMENT IS NOT ASSOCIATED WITH WORSE OUTCOMES IN SINONASAL SQUAMOUS CELL CARCINOMA
Alison Yu, MD1; Isha Thapar, BS1; Shravan Asthana, BS2; Maria Espinosa, MD1; Jennifer Douglas, MD1; Michael Kohanski, MD, PhD1; James Palmer, MD1; Nithin Adappa, MD1; 1University of Pennsylvania; 2Northwestern University
Background: Previous studies have examined the impact of socioeconomic status on the outcomes of head and neck malignancies but very few studies have focused on sinonasal squamous cell carcinoma (SCC) as a unique entity. We sought to investigate the effect of the area deprivation index on the timing of surgery and surveillance following definitive treatment of the disease.
Methods: This was a single institutional retrospective analysis of all patients who underwent resection of primary SCC during a 5-year period from 2018 to 2022. Data on patient demographic information, tumor characteristics, treatment, and surveillance were collected. For each patient, the time from the first preoperative consultation visit to surgery and the time from either surgery or the completion of adjuvant treatment to the first surveillance imaging were additionally calculated. The area deprivation index (ADI) utilizes census-based metrics to assign scores to neighborhoods based on income, housing quality, educational attainment, and employment. The ADI scores were assigned to patients based on their residential address and were further categorized to be higher vs lower than the median ADI score of the study population. Patients with higher ADI scores resided in relatively more disadvantaged communities.
Results: A total of 45 patients with primary sinonasal SCC underwent resection. The mean age was 64.0 (±10.7) years. The majority of the patients were male (71.1%) and white race (82.2%). Most patients had private (46.7%) or Medicare (46.7%) insurance. Extrasinus involvement was present in 53.3% of the patients, and an open/combined approach was necessary in 66.7% of the cases. The mean time between the first preoperative consultation visit and surgery was 18.8 (±10.4) days, and this was significantly greater for patients who had higher ADI scores than those with lower scores (22.7 vs 15.1, p= 0.015). The mean time between treatment completion and the first surveillance imaging was 95.3 (±38.6) days, and this did not differ by ADI scores (p= 0.887). ADI scores also did not vary by extrasinus involvement (p= 0.358), adjuvant treatment (p= 0.279), or type of surgical approach (p= 0.655).
Conclusions: We found that patients with higher ADI scores experienced a significant delay in receiving treatment compared to those with lower ADI scores, suggesting the need to improve access to care for patients living in more disadvantaged communities.