xRead - Nasal Obstruction (September 2024) Full Articles

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151

ICAR SINONASAL TUMORS

TABLE XVI.8 Evidence surrounding recurrence of IP.

Clinical endpoints Recurrence

Study

Year LOE Study design Study groups

Conclusion

Trent et al. 138

1. No single resection technique predicted a propensity for recurrence, but varied on location of pedicle 2. Pedicle in sphenoid sinus with highest recurrence rate (10.4% vs. 5.8% overall) 3. Intraoperative frozen section significantly reduced rates of recurrence (3.4% vs. 7.3%, p = 0.045) Large body of data indicating endoscopic resection has improved ability to prevent 1. IP lesions classified as stage T3 according to the Krouse classification system presented a higher likelihood of recurrence compared to Krouse stage 2 (OR = 1.51, p = 0.01) 2. No significant difference in recurrence between T1 versus T2 or T3 versus T4 IP Factors associated with increased risk for recurrence included young age at initial diagnosis, epithelial dysplasia, and incomplete resection recurrence following resection of IP relative to open approaches (RR = 0.66, p = 0.014 after adjusting for publication bias)

2022 2

Systematic review

Patients with IP treated via

endoscopic, open, and combined resection approaches across 14 studies ( n = 585)

Pengand

2019 2

Systematic

Patients who underwent

Recurrence

Har-El 737

reviewand meta analysis

endoscopic, open, or combined endoscopic and open approaches for resection of IP across 96 studies ( n = 4134) studies undergoing resection of IP via any approach ( n = 1787) Patients with sinonasal papillomas resected via endoscopic or combined open/endoscopic approaches ( n = 101; n = 91with IP) Patients with IP and available preoperative, postoperative, and follow-up serum squamous cell carcinoma antigen values ( n = 130) Patients undergoing maxillary IP resection via endoscopic resection with or without Caldwell Luc, canine fossa trephination, or expanded endoscopic approaches ( n = 155) Patients across 13

Lisan et al. 732

Recurrence

2017 2

Systematic

reviewand meta analysis

Pähler Vor der Holte et al. 730

2020 3

Retrospective cohort

Recurrence

Van Zijl et al. 733

Recurrence

Postoperative SCC antigen is strongly positively associated with risk of recurrence (AUC: 80.9%)

2017 3

Retrospective cohort

Kimet al. 734

2022 4

Retrospective case series

Recurrence

Patients with disease originating from maxillary sinus showed significantly more durable cure rates with expanded endoscopic approaches (medial maxillectomy, prelacrimal approach, etc.) (0.0% [0/28] vs. 10.0% [7/70], p = 0.024)

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