North American Delphi Consensus Study on Sinonasal Malignancy Survivorship Care

BACKGROUND: Survival for patients with sinonasal cancers has improved over the past decades, but there are no dedicated survivorship guidelines for this cohort. OBJECTIVE: To understand experts' priorities and perspectives on key survivorship tenets (surveillance, second tumor screening, toxicity, and symptom management). METHOD: A modified Delphi method was used for developing consensus. A preliminary list of statements was generated from literature review and rated for importance by otolaryngology experts from 15 high-volume North American centers. Statements were rated on a Likert scale and results were discussed. Two Delphi rounds were performed to determine consensus. RESULTS: Consensus was reached for 30 statements. These include the role of endoscopy, imaging, frequency of surveillance stratified by histology and grade, and time following treatment completion. The group reached consensus on the importance of long-term follow-up for symptom and toxicity management, survivorship program enrollment, and recognizing quality of life related issues, including pituitary hormone abnormalities, neurocognition, mental health disorders, sinonasal dysfunction, vision, hearing, dental health, speech and swallowing, and neck morbidity. CONCLUSION: The group reached consensus on key aspects of surveillance, toxicity and symptom management, and the importance of long-term follow-up and enrollment in survivorship programs. Several areas require further research, including the role of second primary tumor screening.