xRead - Nasal Obstruction (September 2024) Full Articles

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ICAR SINONASAL TUMORS

TABLE XIII.2 Evidence surrounding role of salvage surgery for recurrent sinonasal malignancy.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusions

1. Recurrence 2. DFS

Reasonable rate of successful salvage of local ONB recurrence using surgery, RT, or combined surgery and RT

35 studies with 678

Goreand

2011

2

Systematic

Zanation 436

patients with ONB of which 189 experienced local recurrence; 101 were treated with salvage treatment (SS, RT, or CRT)

reviewand meta analysis

Goreand

2009 2

Systematic

33 studies with 678 patients ONB including 79

Successful

Treatment of neck metastases occurring 6 or more months after an initial diagnosis of ONB with combined surgery and RT provides a statistically significant

Zanation 437

reviewand meta analysis

salvage of late neck metastasis (DFS > 1 year)

patients with late neck metastasis ( > 6 months after primary diagnosis), 45hadSS locally recurrent sinonasal cancers treated with salvage surgery 42 patients with locally recurrent SNM underwent 118 patients with

survival advantage versus single-modality therapy

Mattavelli et al. 432

OS

Predictors of OS included primary treatment modality, histology, pT class, margin status, PNI, and adjuvant RT 1. High-risk histologic subtype, grade and orbital and skull base involvement negatively affected OS and/or DFI 2. Improved stratification of patients can be used to guide decision making for patients with recurrent SNM and to avoid inappropriate surgery 1. Patients who did not undergo SS had more advanced disease than those who did 2. Prognosis of the patients who underwent SS were naturally better than those for patients whodidnot 3. Survival rates of the patients undergoing SS was sufficiently high for SS to be recommended 1. Primary surgery resulted in improved OS compared to SS 2. Within the SS group, late stage and positive margins had worse OS feasibility of SS and clinical benefit from palliative chemotherapy are associated with longer OS 2. A multimodal treatment strategy with induction chemotherapy seems to offer improved OS 1. In the recurrent setting,

2022 3

Retrospective cohort

Kaplan et al. 417

2016 3

Retrospective cohort

1. 6-, 12-, and 60-month OS 2. Recurrence 3. DFI 4. Postoperative complica tions 5. LOS

SS ± adjuvant therapy with curative intent

Tsushima et al. 434

OS

2022 4

Retrospective case series

45 patients who had recurrence

following RADPLAT

Lehrich et al. 378

2021

4

Retrospective database review (NCDB)

3011 SNM treated with curative intent with primary surgery ( n = 2804) versus SS ( n = 207) 69 locally advanced (T3 and T4) SNM treated with multimodal treatment of which

1. 30-day and 90-day mortality 2. OS 3. LOS

Orlandi et al. 435

OS

2020 4

Retrospective case series

19 patients with

recurrent disease were treated with SS

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