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Video

Rhinology/Allergy

(A1133) Sex-Based Differences in Sinonasal Cancer Outcomes

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Trevor Bowman, BS

    Medical Student
    Tufts University School of Medicine
    Sherborn, Massachusetts, United States

    • Co-Author(s)

  • Yashas Basavarajappa, BE

    Medical Student
    Tufts University School of Medicine
    Boston, Massachusetts, United States

  • JT

    Jeremiah C. Tracy, MD

    Attending Physician
    Tufts Medical Center
    Boston, Massachusetts, United States

  • Miriam O'Leary, MD

    Chair, Dr. Elie E. Rebeiz Department of Otolaryngology
    Tufts Medical Center
    Newton, Massachusetts, United States

    • Senior Author(s)

  • Christian Soneru, MD

    Assistant Professor
    Tufts Medical Center
    Boston, Massachusetts, United States

Disclosure(s):
Trevor Bowman, BS: No relevant relationships to disclose.
Yashas Basavarajappa, BE: No relevant relationships to disclose.
Jeremiah C. Tracy, MD: No relevant relationships to disclose.
Miriam O'Leary, MD: No relevant relationships to disclose.
Christian Soneru, MD: No relevant relationships to disclose.


Introduction: Sinonasal cancer (SNC) is a rare diagnosis with limited and inconsistent epidemiologic data. Given that SNC is more common in men than women, this study aims to investigate potential sex-based differences in survival among patients with SNC.

Methods: A retrospective analysis was performed using data on patients with pathologically confirmed SNC from the National Cancer Database (NCDB), involving cases diagnosed from 2004 to 2022. Odds ratios were calculated and compared using Fisher’s exact and chi-squared tests. Overall survival was evaluated via Kaplan-Meier analysis. Univariable and multivariable Cox proportional hazards models were used to assess independent predictors of survival, focusing on sex-specific variations.

Results: Sinonasal cancer was identified in 36,777 patients, of which 40.2% (n = 14,794) were female. Men were found to have worse overall survival compared to women (Hazard Ratio (HR) = 1.07, P < 0.001). Notably, the estimated median overall survival time was 10.4 months longer for women than for men (77.2 vs. 66.8 months). Women were more likely than men to receive surgical treatment over strictly nonoperative therapy (Odds Ratio (OR) = 1.07, P = 0.008), and surgical treatment was associated with longer overall survival (HR = 0.45, P < 2e-16). However, women were not significantly more or less likely to receive surgical treatment than men (adjusted OR = 0.92, P = 0.17) when adjusting for possible confounders such as facility type, facility location, age, race, insurance status, income, Charlson-Deyo score, year of diagnosis, primary site, histology, T/N/M scores, stage, grade, and delay from diagnosis to treatment. The trend of overall survival difference between sexes was robust to adjustment for surgical vs. nonsurgical treatment as well as the other possible confounders listed above.

Conclusions: Being male is associated with poorer survival from sinonasal cancer, a finding not easily explained by potential confounders in the initial presentation, like the stage of disease, delay to treatment, or treatment modality. More research is needed to identify possible causes for this difference.