The Role of Elective Neck Treatment in the Management of Sinonasal Carcinomas: A Systematic Review of the Literature and a Meta-Analysis
by
, , , and
Costanza Galloni
1,†, 
Luca Giovanni Locatello
1,*,†,
Chiara Bruno
1,
Angelo Cannavicci
1,
Giandomenico Maggiore
1 and
Oreste Gallo
1,2 1
Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
2
Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
*
Author to whom correspondence should be addressed.
†
Both equally contributed to the present work.
Cancers 2021, 13(8), 1842; https://doi.org/10.3390/cancers13081842
Submission received: 2 March 2021
/
Revised: 2 April 2021
/
Accepted: 8 April 2021
/
Published: 13 April 2021
(This article belongs to the Special Issue Sinonasal Cancer: Improving Classification, Stratification and Therapeutic Options)
Simple Summary
The impact of elective neck treatment (ENT), whether by irradiation or dissection, on the prognosis of patients with cN0 sinonasal carcinomas remains an understudied issue. A systematic review and meta-analysis of the literature were performed according to PRISMA guidelines in order to assess regional recurrence rates after elective neck treatment compared to observation in cN0 patients. Twenty-six articles for a total of 1178 clinically N0 patients were analyzed. Overall, the 5-year overall survival was 52%; 34.6% of patients underwent elective treatment of the neck and 140 regional recurrences were registered. ENT appears to confer a lower risk of regional recurrence compared to observation alone with a cumulative OR of 0.38 (95% CI 0.25–0.58). Our meta-analysis supports the efficacy of ENT in order to reduce the risk of regional recurrence but the overall impact on survival remains uncertain.
Abstract
The impact of elective neck treatment (ENT), whether by irradiation or dissection, on the prognosis of patients with cN0 sinonasal carcinomas (SNCs) remains an understudied issue. METHODS: A systematic review and meta-analysis of the literature were performed according to PRISMA guidelines in order to assess regional nodal relapse rate after ENT compared to observation in cN0 SNCs patients. Twenty-six articles for a total of 1178 clinically N0 patients were analyzed. Globally, the 5-year overall survival was 52%; 34.6% of patients underwent ENT and 140 regional recurrences were registered (5.9% in the ENT cohort and 15% in the observation group). ENT appears to confer a lower risk of regional recurrence compared to observation alone, with a cumulative OR of 0.38 (95% CI 0.25–0.58). Our meta-analysis supports the efficacy of ENT for reducing the risk of regional recurrence, but its overall impact on survival remains uncertain.
