-
JAMA Otolaryngology-- Head & Neck... Nov 2017The risk factors for the recurrence of sinonasal inverted papilloma are still unclear. (Meta-Analysis)
Meta-Analysis Review
IMPORTANCE
The risk factors for the recurrence of sinonasal inverted papilloma are still unclear.
OBJECTIVE
To investigate the potential association between the Krouse classification and the recurrence rates of sinonasal inverted papilloma.
DATA SOURCES
The EMBASE and MEDLINE databases were searched for the period January 1, 1964, through September 30, 2016, using the following search strategy: (paranasal sinuses [Medical Subject Headings (MeSH) terms] OR sinonasal [all fields]) AND (inverted papilloma [MeSH terms] OR (inverted [all fields] AND papilloma [all fields]).
STUDY SELECTION
The inclusion criteria were (1) studies including sinonasal inverted papilloma only and no other forms of papillomas, such as oncocytic papilloma; (2) minimum follow-up of 1 year after the surgery; and (3) clear report of cases (recurrence) and controls according to the Krouse classification system or deducible from the full-text article. Literature search was performed by 2 reviewers. Of the 625 articles retrieved in the literature, 97 full-text articles were reviewed. Observational cohort studies or randomized controlled trials were included, and the following variables were extracted from full-text articles: authors of the study, publication year, follow-up data, and number of cases (recurrence) and controls (no recurrence) in each of the 4 stages of the Krouse classification system.
DATA EXTRACTION AND SYNTHESIS
The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Odds ratios (ORs) and 95% CIs were estimated, and data of included studies were pooled using a random-effects model.
MAIN OUTCOMES AND MEASURES
The main outcome was recurrence after surgical removal of sinonasal inverted papilloma according to each stage of the Krouse classification system.
RESULTS
Thirteen studies comprising 1787 patients were analyzed. A significant increased risk of recurrence (51%) was highlighted for Krouse stage T3 disease when compared with stage T2 (pooled OR, 1.51; 95% CI, 1.09-2.09). No significant difference in risk of recurrence was found between Krouse stages T1 and T2 disease (pooled OR, 1.14; 95% CI, 0.63-2.04) or between stages T3 and T4 (pooled OR, 1.27; 95% CI, 0.72-2.26).
CONCLUSIONS AND RELEVANCE
Inverted papillomas classified as stage T3 according to the Krouse classification system presented a 51% higher likelihood of recurrence. Head and neck surgeons must be aware of this higher likelihood of recurrence when planning and performing surgery for sinonasal inverted papilloma.
Topics: Humans; Neoplasm Recurrence, Local; Neoplasm Staging; Papilloma, Inverted; Paranasal Sinus Neoplasms; Patient Care Planning
PubMed: 28973390
DOI: 10.1001/jamaoto.2017.1686 -
Annals of the Royal College of Surgeons... Apr 2020Parietal cell/oncocytic gastric carcinomas are very rare and various aspects of this group remain unclear. The human epithelial growth factor receptor 2 (HER2) status of...
INTRODUCTION
Parietal cell/oncocytic gastric carcinomas are very rare and various aspects of this group remain unclear. The human epithelial growth factor receptor 2 (HER2) status of these tumours is largely unknown.
METHODS
We performed a systematic electronic search of the literature and clinicopathological presentation of two cases including first-time complete assessment of HER2 status. Thirty-two patients with a mean age of 64.3 years, 87.5% of whom were male, were included in this review.
FINDINGS
Half of the cases were recorded in Asia. Median follow-up was 24 months. There was no predominant site of development, while underlying histological abnormalities were present in 25%. At initial presentation, lymph node involvement was evident in 46.6% while distant metastatic disease was present in 9.3%. Presentation at stage I occurred in 55.6%. Potentially curative surgical/interventional treatment was intended in 90.6%. Recurrence occurred in 6.6%, while death was recorded in 19.2%, with cancer-related deaths reaching 11.5%. The one- and three-year survival rates were 84.2% and 79%, respectively. Our two cases displayed negative HER2 expression.
CONCLUSIONS
This systematic review demonstrates that this group of malignancies is very rare but possibly underdiagnosed. The disease commonly presents at early stage, mainly affecting middle-aged men. The prognosis is generally favourable even in cases of advanced disease. The HER2 expression and its correlation with the outcomes need to be further explored.
Topics: Aged, 80 and over; Biomarkers, Tumor; Carcinoma; Chemotherapy, Adjuvant; Disease-Free Survival; Female; Gastrectomy; Greece; Humans; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence, Local; Parietal Cells, Gastric; Receptor, ErbB-2; Sex Factors; Stomach Neoplasms; Survival Rate
PubMed: 31928359
DOI: 10.1308/rcsann.2019.0183