Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients

Background 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. Methods 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. Results 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. Conclusion 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.