2025 Proffered Presentations
S086: IMPACT OF ORBITAL PRESERVATION VS ORBITAL EXENTERATION IN ADVANCED SINONASAL SQUAMOUS CELL CARCINOMA- SYSTEMATIC REVIEW AND META-ANALYSIS
Srivatsa Surya Vasudevan, MD, MS; MacKenzie Latour, MD; Michael Yim, MD; LSU Health Shreveport
Background: In sinonasal carcinoma (SNC) treatment, the decision between orbital exenteration and preservation can be crucial for patient survival. Our primary objective is to analyze the differences in outcomes between orbital preservation (OP) and orbital exenteration (OE) specifically in advanced sinonasal squamous cell carcinoma (SCC) patients.
Methods: PubMed, Embase, Web of Science, and ScienceDirect databases were searched from inception to March 15, 2024, for studies comparing survival outcomes between orbital exenteration (OE) and orbital preservation (OP) in sinonasal carcinoma. A random-effects meta-analysis assessed hazard ratios (HRs) and 95% confidence intervals for overall survival (OS) and odds ratio (OR) for recurrence rates.
Results: Following 320 articles screening, 5 studies with 209 advanced (T3-T4) sinonasal SCC patients were included. There was no statistically significant advantage of survival in orbital exenteration for 1-year OS (HR: 0.58 [95% CI: 0.10-3.26], p = 0.53), 2-year OS (HR: 1.16 [95% CI: 0.42-3.24], p = 0.77) (Figure 1), 3-year OS (HR: 1.03 [95% CI: 0.44-2.42], p = 0.95) and 5-year OS (HR: 1.08 [95% CI: 0.55-2.12], p = 0.81) (Figure 2). Similarly comparable recurrence rates were analyzed between OE and OP (OR: 0.50 [95% CI: 0.18-1.40], p = 0.19) (Figure 3). Furthermore, sensitivity analysis with a one-study removal method indicated no significant variation in the survival outcomes between OE and OP.
Conclusion: This systematic review and meta-analysis highlight that there was no statistically significant advantage of orbital exenteration over orbital preservation in the overall survival in advanced sinonasal SCC. Additionally, comparable local recurrent rates were observed between the two groups.
