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ICAR SINONASAL TUMORS

TABLE X.6 Evidence surrounding overall outcomes in open versus endoscopic approach for sinonasal malignancies.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Jiang et al. 298

1. OS 2. DFS

EEA survival was comparable or better than the open approach

1373 patients from 23 studies

2022 2

Systematic

reviewand meta analysis reviewand meta analysis

EEA( n = 653) Open ( n = 720)

Higgins et al. 312

2011

2

Systematic

226 patients from 15 studies EEA( n = 56) Open ( n = 101) Other ( n = 69, not 900 patients from 10 studies EEA( n = 399) Open ( n = 501)

1. OS 2. DFS 3. LRC

1. EEA is comparable to open approach for low-stage disease 2. In late-stage malignancies, 5-year survival and LRC rates were highly variable in EEA Compared to open resection, EEA exhibits complications and disease recurrence and may result in a shorter LOS 1. Compared to open approach, EEA improved 3-year LRC, OS, andPFS 2. EEA reduced need for transfusion, surgical time, cost, andLOS Compared to EEA, open resection with or without an endoscopic component was associated with increased odds of developing a complication

included in analysis)

Luet al. 313

1. Complications 2. LOS 3. Recurrence 1. LRC 2. OS 3. PFS 4. Operative time 5. LOS 6. Complications

2019 2

Systematic

reviewand meta analysis

Caballero Garcia et al. 294

2022 3

Retrospective cohort

50 patients EEA( n = 25) Open ( n = 25)

Beswick et al. 14

Complications

2021 3

Prospective cohort

142 patients EEA( n = 98) Open ( n = 44, open resection with or

without an endoscopic component)

Rutland et al. 282

2021 3

Retrospective cohort

60 patients EEA( n = 30) Open ( n = 30)

1. GTR 2. Intraoperative blood loss 3. Operative time 4. LOS 5. Complications

EEA had shorter surgeries, lower intraoperative blood loss, and shorter LOS with similar GTR and complication rates

Hagemann et al. 290

1. OS 2. DSS

Similar OS and DSS between EEA and open approaches for low-stage tumors (T1–2) and locally extensive high-stage tumors (T4), with better survival in the EEA group for T3 tumors EEA has a longer operative time, more CSF leaks, and longer ICU stay than the open group without free flap reconstruction EEA may provide improved OS and DFS and shorter LOS

2019 3

Retrospective cohort

225 patients EEA( n = 123) Open ( n = 102)

Fuet al. 291

2017 3

Retrospective cohort

106 patients EEA( n = 15) Open ( n = 91) 124 patients EEA( n = 82) Open ( n = 42)

1. Operative time 2. LOS 3. CSF leak

Farquhar et al. 292

1. OS 2. DFS 3. LOS

2016 3

Retrospective cohort

Naunheim et al. 285

2016 3

Retrospective cohort

67 patients EEA( n = 10) Cranioendoscopic resection ( n = 12) Open ( n = 45)

1. OS 2. DSS 3. Complications

1. OS, DSS, and most

complications were similar between approaches 2. Open transfacial incisions

predisposed patients to surgical site infection (Continues)