选择性颈部治疗在鼻窦癌管理中的作用：文献系统综述与荟萃分析

The Role of Elective Neck Treatment in the Management of Sinonasal Carcinomas: A Systematic Review of the Literature and a Meta-Analysis.

作者信息

Galloni Costanza, Locatello Luca Giovanni, Bruno Chiara, Cannavicci Angelo, Maggiore Giandomenico, Gallo Oreste

机构信息

Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy.

Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy.

出版信息

Cancers (Basel). 2021 Apr 13;13(8):1842. doi: 10.3390/cancers13081842.

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.

选择性颈部治疗（ENT），无论是通过放疗还是手术切除，对cN0期鼻窦癌（SNC）患者预后的影响仍是一个研究不足的问题。方法：根据PRISMA指南对文献进行系统综述和荟萃分析，以评估cN0期SNC患者接受ENT治疗与观察相比的区域淋巴结复发率。分析了26篇文章，共1178例临床N0期患者。总体而言，5年总生存率为52%；34.6%的患者接受了ENT治疗，记录到140例区域复发（ENT队列中为5.9%，观察组中为15%）。与单纯观察相比，ENT似乎能降低区域复发风险，累积OR为0.38（95%CI 0.25-0.58）。我们的荟萃分析支持ENT在降低区域复发风险方面的有效性，但其对生存的总体影响仍不确定。