Jiang S, Fan R, Zhang H, Jiang W, Xie Z. Outcomes of endoscopic and open resection of sinonasal malignancies: a systematic review and meta-analysis.
Braz J Otorhinolaryngol 2021;
88 Suppl 5:S19-S31. [PMID:
34348855 PMCID:
PMC9800954 DOI:
10.1016/j.bjorl.2021.06.004]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 01/02/2023] Open
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 utilized 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.
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