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Πέμπτη 5 Αυγούστου 2021

Outcomes of endoscopic and open resection of sinonasal malignancies: a systematic review and meta-analysis

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Braz J Otorhinolaryngol. 2021 Jul 20:S1808-8694(21)00127-0. doi: 10.1016/j.bjorl.2021.06.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the efficacy of endoscopic and open resection of sinonasal malignancies.

METHODS: The search was performed using PubMed (1950-2020), Embase (1974-2020), the Cochrane library, and the website clinicaltrials.gov. The hazard ratio, HR, 95% confidence interval, CI, of the rates of overall survival and disease-free survival and the demographic characteristics of the included studies were extracted and analyzed. Pooled analysis was conducted with the studies' individual patient data, using log-rank test, Kaplan-Meier survival, and Cox regression analysis.

RESULTS: Of 1939 articles retrieved, 23 articles were included. Overall, 1373 cases were incorporated into the final analysis, 653 (47.56%) of which underwent the surgery through an endoscopic approach, whereas 720 (52.44%) cases uti lized the open approach. The overall survival was comparable between endoscopic and open resection (HR = 0.84 [95% CI: 0.65-1.07], p = 0.16; random effects analysis). Pooled analysis with Cox regression revealed signifcant differences in overall survival (HR = 0.568 [95%CI:0.380-0.849], p = 0.006) and disease-free survival (HR = 0.628 [95%CI:0.424-0.929], p = 0.02) between endoscopic and open approaches.

CONCLUSION: The aggregated evidence suggests the survival outcome of endoscopic resection is comparable or greater than that of open resection of sinonasal malignancies.

PMID:34348855 | DOI:10.1016/j.bjorl.202 1.06.004

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