Outcomes of sinonasal inverted papilloma resection by surgical approach: an updated systematic review and meta‐analysis
Rui Peng MD Andrew Thamboo MD Garret Choby MD Yifei Ma MS Bing Zhou MD, PhD Peter H. Hwang MD
First published: 12 February 2019 https://doi.org/10.1002/alr.22305 Cited by: 1
Potential conflict of interest: None provided.
Presented at the American Rhinologic Society Annual Meeting on October 5‐6, 2018, in Atlanta, GA.
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Abstract
Background
Selecting the optimal surgical approach for resection of sinonasal inverted papilloma (SIP) remains a challenge, with endoscopic, external, and combined approaches being utilized. This systematic review was conducted as an update to a 2006 systematic review to determine the preferred surgical approach for tumor control.
Methods
The study protocol was developed a priori following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) process. Data were collected and outcomes were analyzed according to surgical approach and sites of tumor involvement.
Results
A total of 96 papers and 4134 SIP patients were included. The overall recurrence rate was 12.80% (322/2515) for the endoscopic approach group, 16.58% (182/1098) for the external approach group, and 12.60% (65/516) for the combined approach group. Meta‐analysis by random effects model showed that the summarized risk ratio (RR) of recurrence was 0.61 (95% confidence interval [CI], 0.44 to 0.85, p = 0.003), I2 = 37.95% for the endoscopic vs external approach; 0.98 (95% CI, 0.69 to 1.39, p = 0.901), I2 = 9.06% for the endoscopic vs combined approach; 1.61 (95% CI, 1.06 to 2.43, p = 0.025), I2 = 0.00% for the external vs combined approach. After adjusting for publication bias, the adjusted RRs were 0.66 (p = 0.014) for endoscopic vs external; 0.99 (p = 0.955) for endoscopic vs combined; and 1.33 (p = 0.224) for external vs combined.
Conclusion
An enlarging and maturing body of literature continues to indicate that endoscopic approaches result in significantly lower recurrence rates than open approaches for surgical resection of SIP.
Rui Peng MD Andrew Thamboo MD Garret Choby MD Yifei Ma MS Bing Zhou MD, PhD Peter H. Hwang MD
First published: 12 February 2019 https://doi.org/10.1002/alr.22305 Cited by: 1
Potential conflict of interest: None provided.
Presented at the American Rhinologic Society Annual Meeting on October 5‐6, 2018, in Atlanta, GA.
Read the full text
ePDFPDFTOOLS SHARE
Abstract
Background
Selecting the optimal surgical approach for resection of sinonasal inverted papilloma (SIP) remains a challenge, with endoscopic, external, and combined approaches being utilized. This systematic review was conducted as an update to a 2006 systematic review to determine the preferred surgical approach for tumor control.
Methods
The study protocol was developed a priori following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) process. Data were collected and outcomes were analyzed according to surgical approach and sites of tumor involvement.
Results
A total of 96 papers and 4134 SIP patients were included. The overall recurrence rate was 12.80% (322/2515) for the endoscopic approach group, 16.58% (182/1098) for the external approach group, and 12.60% (65/516) for the combined approach group. Meta‐analysis by random effects model showed that the summarized risk ratio (RR) of recurrence was 0.61 (95% confidence interval [CI], 0.44 to 0.85, p = 0.003), I2 = 37.95% for the endoscopic vs external approach; 0.98 (95% CI, 0.69 to 1.39, p = 0.901), I2 = 9.06% for the endoscopic vs combined approach; 1.61 (95% CI, 1.06 to 2.43, p = 0.025), I2 = 0.00% for the external vs combined approach. After adjusting for publication bias, the adjusted RRs were 0.66 (p = 0.014) for endoscopic vs external; 0.99 (p = 0.955) for endoscopic vs combined; and 1.33 (p = 0.224) for external vs combined.
Conclusion
An enlarging and maturing body of literature continues to indicate that endoscopic approaches result in significantly lower recurrence rates than open approaches for surgical resection of SIP.
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