Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients.
Surgical resection represents the gold standard for the treatment of sinonasal malignancies. This study reviewed the published outcomes on endoscopic surgery or endoscopic-assisted surgery versus open approach for the management of sinonasal adenocarcinomas.



PubMed, EMBASE, the Cochrane Library, and CENTRAL electronic databases were searched for English language articles on endoscopic surgery, endoscopic-assisted surgery, and open approach for sinonasal adenocarcinomas. Each article was examined for patient data and outcomes for analysis.



Thirty-nine articles including 1826 patients were used for the analysis. The endoscopic surgery and endoscopic-assisted surgery showed low rates of major complications (6.6% and 25.9%, respectively) compared to open approaches (36.4%; p < .01). The incidence of local failure was lower in the endoscopic surgery group as compared with open approach patients (17.8% vs 38.5%; p < .01, respectively). The multivariate Cox regression model showed a worst overall survival related to advanced T classification and open approach.



From the existing body of data, there is growing evidence that endoscopic nasal resection is a safe surgical option in the management of sinonasal adenocarcinomas. © 2015 Wiley Periodicals, Head Neck 38: E2267-E2274, 2016.
Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Giuseppe
G
Meccariello
Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Alberto
A
Deganello
ENT Department, Rouen University Hospital, Rouen, France.
Olivier
O
Choussy
Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Oreste
O
Gallo
Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
Daniele
D
Vitali
ENT Department, Comprehensive Cancer Centre, Caen, France.
Dominique
D
De Raucourt
Endoscopic Skull Base Center, Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Christos
C
Georgalas
D000230:Adenocarcinoma / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D059747:Nasal Surgical Procedures / Q000379:methods*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
adenocarcinoma; endoscopy; paranasal sinus; patient outcome assessment; postoperative complications