xRead - Nasal Obstruction (September 2024) Full Articles

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KUANetal.

TABLE XXII.C.1 Evidence for extent of surgery and adjuvant therapy in sinonasal ACC.

Clinical endpoints

Study

Year LOE Study design Study groups

Conclusion

Husain et al. 73

OS

Surgery followed by adjuvant RT was correlated with the highest survival outcomes

Compiled data of sinonasal ACC

2013 2

Systematic

reviewand meta analysis

patients treated with different therapeutic combinations ( n = 88 encompassing 55 studies) patients treated with surgical resection with or without adjuvant treatment ( n = 520) patients treated with primary surgical excision or RT/CRT ( n = 105) Endoscopic surgical resection with adjuvant RT for patients with sinonasal ACC ( n = 30) Patients with sinonasal ACC treated surgically with endoscopic, open, or combined approach followed by adjuvant RT ( n = 32) Endoscopic surgical resection with or without adjuvant RT for patients with sinonasal ACC ( n = 34) Patients with sinonasal ACC treated with either surgery, RT, or chemotherapy ( n = 793) Sinonasal ACC Sinonasal ACC

Amit et al. 75

2013 3

Systematic

1. OS 2. DFS

Negative surgical margins and tumor origin from nasal cavity or maxillary sinus are correlated with improved survival

reviewand meta analysis of retrospective case series

Lupinetti et al. 79

1. Surgery with postoperative RT provides the best OS and DSS compared with other treatment modalities 2. Primary treatment with surgery as opposed to RT or chemotherapy significantly improved survival Organ-preserving EEA with adjuvant RT for sinonasal ACC patients with low-grade tumors has similar OS outcome as open approach with more aggressive resection 1. Surgical resection when feasible is the treatment of choice even without achieving clear margins 2. Adjuvant therapy improves survival and local control 1. Endoscopic approach when feasible has comparable outcomes to open approach 2. Negative surgical margins and adjuvant RT are associated with improved survival rates 1. Surgery was the only predictor for improved OS 2. Frontal sinus primary site, positive margins, poorly differentiated or

1. OS 2. DSS 3. Local control

2007 3

Retrospective cohort

Kashiwazaki et al. 1199

2020 4

Retrospective case series

1. OS 2. DFS

Guazzo et al. 494

1. OS 2. RFS

2019 4

Retrospective multicenter review

Volpi et al. 106

2019 4

Retrospective case series

1. OS 2. DSS 3. RFS

Trope et al. 376

OS

2019 4

Retrospective, NCDB database study

undifferentiated tumor grade, and advanced tumor stage were associated with worse OS (Continues)