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REFCOR guidelines for sinonasal adenocarcinoma
L de Gabory1, C Monnot1, A-C Baglin2
1Service d'ORL et Chirurgie Cervico-Faciale, Centre Michelet, Hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; Université de Bordeaux, Bordeaux, France.
Introduction:
Since 2009, management of sinonasal adenocarcinoma (ADK) was governed by general guidelines. The present paper presents an update.
Method:
The formalized expert consensus methodology was applied. A literature analysis for the period 2009-2020 in the PubMed and Cochrane Library databases selected 60 studies meeting the PRISMA criteria. Eighteen recommendations were drawn up and validated.
Results:
For T1 and T2N0M0 intestinal ADK and low-grade non-intestinal ADK, isolated surgery with negative margins is recommended (Relative agreement). For pT2 and pT3N0M0 intestinal ADK with negative resection margins, tumor-board discussion of adjuvant radiotherapy is recommended (Relative agreement). Complete resection with negative margins followed by radiotherapy to the tumor bed is the curative treatment for T4N0M0 intestinal ADK (Strong agreement) and N0M0 high-grade non-intestinal ADK of whatever stage (Relative agreement). Prophylactic cervical lymph-node treatment is not recommended in N0 sinonasal ADK (Relative agreement).
Conclusion:
The present update defines specific recommendations for this histologic family.
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