目的:综合分析鼻泪腺鳞状细胞癌(NLSCC)的报道,关注风险因素,治疗方式,和结果。此外,研究人乳头瘤病毒(HPV)状态和组织病理学亚型对预后的影响。
方法:发布,Embase.
方法:我们进行了系统的文献综述,以确定报告NLSCC病例的相关研究。审查方法遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目。最终更新于2023年5月31日进行。
结果:72项研究共包括313名参与者(平均年龄:55岁;60%为男性)。症状持续时间较长(44.1±59.2个月)与复发相关(p=0.004),和男性表现出更高的死亡率(19.6%vs.2.4%的女性,p=0.01)。所有患者的总生存率(OS)为87.1%。BasaloidNLSCC的死亡结局较差(p≤0.001)。HPV阳性病例显示具有可比性的OS,复发,和普通人群的转移率(分别为p=0.917、0.851、0.07)。比较治疗方法(手术,辅助放射手术,放化疗[CRT],然后手术),未观察到5年和10年OS率或复发率的显着差异(分别为p=0.4,0.24),但5年转移事件是显著的(p=0.024).眼部切除术率为31.1%,20%,和各自处理的0%(p=0.089)。诱导化疗使4例患者免于潜在的放血,预后良好。
结论:早期发现和诊断在NLSCC的治疗中至关重要。不管治疗方法如何,HPV相关的NLSCC表现出与普通人群相似的结果。Basaloid组织学代表预后最差的亚型。在最近的文献和我们共同的经验中,有限的辅助CRT病例显示出改善的结果和诱导化疗的重要性。喉镜,2024.
OBJECTIVE: To comprehensively analyze reported cases of nasolacrimal squamous cell carcinoma (NLSCC), focusing on risk factors, treatment modalities, and outcomes. Additionally, investigate the impact of human Papillomavirus (HPV) status and histopathological subtypes\' impact on prognosis.
METHODS: Pubmed, Embase.
METHODS: We conducted a systematic literature
review to identify relevant studies reporting cases of NLSCC. The
review methods adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The final update was performed on May 31, 2023.
RESULTS: The 72 studies included a total of 313 participants (mean age: 55; 60% male). Longer symptom duration (44.1 ± 59.2 months) correlated with recurrence (p = 0.004), and males exhibited higher mortality rates (19.6% vs. 2.4% in females, p = 0.01). The overall survival (OS) rate among all patients was 87.1%. Basaloid NLSCC had a worse death outcome (p ≤ 0.001). HPV-positive cases showed comparable OS, recurrence, and metastasis rates to the general population (p = 0.917, 0.851, 0.07, respectively). Comparing treatment approaches (surgery, surgery with adjuvant radiation, chemoradiotherapy [CRT] followed by surgery), no significant differences in 5 and 10-year OS rates or recurrence were observed (p = 0.4, 0.24, respectively), but 5-year metastasis events were significant (p = 0.024). Eye exenteration rates were 31.1%, 20%, and 0% for the respective treatments (p = 0.089).
Induction chemotherapy saved four cases from potential exenteration with favorable prognosis.
CONCLUSIONS: Early detection and diagnosis are of utmost importance in the management of NLSCC. Regardless of the treatment approach, HPV-related NLSCC demonstrated similar outcomes to the general population. Basaloid histology represents the worst subtype in terms of prognosis. Limited adjuvant CRT cases showed improved outcomes and
induction chemotherapy\'s importance was emphasized in recent literature and our shared experience. Laryngoscope, 134:3892-3902, 2024.