Gender-based survival analysis in Nasal-Sinus Cancer: a resampling approach using a registry data

Abstract Background Nasal-Sinus Cancers (NSCs) develop in the nasal cavities or paranasal sinuses and account for approximately 1% of all malignant neoplasms. Survival in NSCs varies by several factors, including gender. However, small sample sizes in tumor registries may hinder the detection of significant survival differences. This study aims to investigate gender-based survival disparities in NSCs using resampling techniques to overcome such limitations and provide robust survival estimates. Methods We analyzed data from a tumor registry including NSCs cases diagnosed between 2016 and 2020. Due to limited cases (35 subjects), resampling was used to create two equal groups of 1,000 male and 1,000 female patients. Kaplan-Meier curves were generated by gender, and survival differences were tested using the log-rank test. The analyses were performed in R. Results Kaplan-Meier survival curves revealed clear differences between genders. The log-rank test showed a significant difference (p < 0.001), with males having a lower survival probability. Median survival was 48.3 months for females and 36.7 months for males. At 12 months, survival probability was 85% for females and 75% for males; at 24 months, 65% and 55%, respectively, confirming a consistent gender-based survival gap. Conclusions This analysis shows marked gender disparities in NSCs survival. Resampling allowed for a more stable estimation despite small initial samples. These findings suggest gender is a relevant prognostic factor and should be considered in clinical decisions. Further research should explore the causes behind these disparities, while health policies and treatment strategies must be tailored to address them. Key messages • Women with nasal-sinus cancer show significantly better survival than men: 48.3 vs 36.7 months (p < 0.001). • Resampling revealed gender survival disparities in NSCs, highlighting the need for gender-informed treatment strategies.