Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes
Background: The outcomes of orbital exenteration (OE) in patients with craniofacial lesions (CFLs) remain unclear. The present review summarizes the available literature on the clinical outcomes of OE, including surgical outcomes and overall survival (OS). Methods: Relevant articles were retrieved f...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/17/4285 |
| _version_ | 1797582761873113088 |
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| author | Jumanah Qedair Ali S. Haider Kishore Balasubramanian Paolo Palmisciano Taimur Hassan Ataollah Shahbandi Mohammadmahdi Sabahi Abdurrahman F. Kharbat Hussam Abou-Al-Shaar Kenny Yu Aaron A. Cohen-Gadol Tarek Y. El Ahmadieh Othman Bin-Alamer |
| author_facet | Jumanah Qedair Ali S. Haider Kishore Balasubramanian Paolo Palmisciano Taimur Hassan Ataollah Shahbandi Mohammadmahdi Sabahi Abdurrahman F. Kharbat Hussam Abou-Al-Shaar Kenny Yu Aaron A. Cohen-Gadol Tarek Y. El Ahmadieh Othman Bin-Alamer |
| author_sort | Jumanah Qedair |
| collection | DOAJ |
| description | Background: The outcomes of orbital exenteration (OE) in patients with craniofacial lesions (CFLs) remain unclear. The present review summarizes the available literature on the clinical outcomes of OE, including surgical outcomes and overall survival (OS). Methods: Relevant articles were retrieved from Medline, Scopus, and Cochrane according to PRISMA guidelines. A systematic review and meta-analysis were conducted on the clinical characteristics, management, and outcomes. Results: A total of 33 articles containing 957 patients who underwent OE for CFLs were included (weighted mean age: 64.3 years [95% CI: 59.9–68.7]; 58.3% were male). The most common lesion was squamous cell carcinoma (31.8%), and the most common symptom was disturbed vision/reduced visual acuity (22.5%). Of the patients, 302 (31.6%) had total OE, 248 (26.0%) had extended OE, and 87 (9.0%) had subtotal OE. Free flaps (33.3%), endosseous implants (22.8%), and split-thickness skin grafts (17.2%) were the most used reconstructive methods. Sino-orbital or sino-nasal fistula (22.6%), flap or graft failure (16.9%), and hyperostosis (13%) were the most reported complications. Regarding tumor recurrences, 38.6% were local, 32.3% were distant, and 6.7% were regional. The perineural invasion rate was 17.4%, while the lymphovascular invasion rate was 5.0%. Over a weighted mean follow-up period of 23.6 months (95% CI: 13.8–33.4), a weighted overall mortality rate of 39% (95% CI: 28–50%) was observed. The 5-year OS rate was 50% (median: 61 months [95% CI: 46–83]). The OS multivariable analysis did not show any significant findings. Conclusions: Although OE is a disfiguring procedure with devastating outcomes, it is a viable option for carefully selected patients with advanced CFLs. A patient-tailored approach based on tumor pathology, extension, and overall patient condition is warranted. |
| first_indexed | 2024-03-10T23:27:06Z |
| format | Article |
| id | doaj.art-cf8573002a0247abab9078da8e92a092 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T23:27:06Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-cf8573002a0247abab9078da8e92a0922023-11-19T07:55:41ZengMDPI AGCancers2072-66942023-08-011517428510.3390/cancers15174285Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival OutcomesJumanah Qedair0Ali S. Haider1Kishore Balasubramanian2Paolo Palmisciano3Taimur Hassan4Ataollah Shahbandi5Mohammadmahdi Sabahi6Abdurrahman F. Kharbat7Hussam Abou-Al-Shaar8Kenny Yu9Aaron A. Cohen-Gadol10Tarek Y. El Ahmadieh11Othman Bin-Alamer12College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi ArabiaDepartment of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USATexas A&M School of Medicine, Texas A&M University, Houston, TX 77030, USADepartment of Neurological Surgery, University of California, Davis, Sacramento, CA 95819, USATexas A&M School of Medicine, Texas A&M University, Houston, TX 77030, USATehran School of Medicine, Tehran University of Medical Science, Tehran 1416634793, IranDepartment of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL 33331, USADepartment of Neurosurgery, The University of Oklahoma, Oklahoma City, OK 73019, USADepartment of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USADepartment of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USADepartment of Neurosurgery, Loma Linda University, Loma Linda, CA 92354, USADepartment of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15219, USABackground: The outcomes of orbital exenteration (OE) in patients with craniofacial lesions (CFLs) remain unclear. The present review summarizes the available literature on the clinical outcomes of OE, including surgical outcomes and overall survival (OS). Methods: Relevant articles were retrieved from Medline, Scopus, and Cochrane according to PRISMA guidelines. A systematic review and meta-analysis were conducted on the clinical characteristics, management, and outcomes. Results: A total of 33 articles containing 957 patients who underwent OE for CFLs were included (weighted mean age: 64.3 years [95% CI: 59.9–68.7]; 58.3% were male). The most common lesion was squamous cell carcinoma (31.8%), and the most common symptom was disturbed vision/reduced visual acuity (22.5%). Of the patients, 302 (31.6%) had total OE, 248 (26.0%) had extended OE, and 87 (9.0%) had subtotal OE. Free flaps (33.3%), endosseous implants (22.8%), and split-thickness skin grafts (17.2%) were the most used reconstructive methods. Sino-orbital or sino-nasal fistula (22.6%), flap or graft failure (16.9%), and hyperostosis (13%) were the most reported complications. Regarding tumor recurrences, 38.6% were local, 32.3% were distant, and 6.7% were regional. The perineural invasion rate was 17.4%, while the lymphovascular invasion rate was 5.0%. Over a weighted mean follow-up period of 23.6 months (95% CI: 13.8–33.4), a weighted overall mortality rate of 39% (95% CI: 28–50%) was observed. The 5-year OS rate was 50% (median: 61 months [95% CI: 46–83]). The OS multivariable analysis did not show any significant findings. Conclusions: Although OE is a disfiguring procedure with devastating outcomes, it is a viable option for carefully selected patients with advanced CFLs. A patient-tailored approach based on tumor pathology, extension, and overall patient condition is warranted.https://www.mdpi.com/2072-6694/15/17/4285orbital exenterationcraniofacialcarcinomasurvivaloutcomessystematic review |
| spellingShingle | Jumanah Qedair Ali S. Haider Kishore Balasubramanian Paolo Palmisciano Taimur Hassan Ataollah Shahbandi Mohammadmahdi Sabahi Abdurrahman F. Kharbat Hussam Abou-Al-Shaar Kenny Yu Aaron A. Cohen-Gadol Tarek Y. El Ahmadieh Othman Bin-Alamer Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes Cancers orbital exenteration craniofacial carcinoma survival outcomes systematic review |
| title | Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes |
| title_full | Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes |
| title_fullStr | Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes |
| title_full_unstemmed | Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes |
| title_short | Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes |
| title_sort | orbital exenteration for craniofacial lesions a systematic review and meta analysis of patient characteristics and survival outcomes |
| topic | orbital exenteration craniofacial carcinoma survival outcomes systematic review |
| url | https://www.mdpi.com/2072-6694/15/17/4285 |
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