REFCOR guidelines for sinonasal adenocarcinoma

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Oncology

Background:

• Management of sinonasal adenocarcinoma (ADK) previously relied on general guidelines.
• An update is provided based on recent literature and expert consensus.

Purpose of the Study:

• To establish specific, evidence-based recommendations for sinonasal adenocarcinoma management.
• To update clinical practice for this rare cancer histology.

Main Methods:

• Formalized expert consensus methodology.
• Systematic literature review (2009-2020) of PubMed and Cochrane Library.
• Selection of 60 studies based on PRISMA criteria.
• Validation of 18 expert recommendations.

Main Results:

• Surgery with negative margins is recommended for early-stage intestinal ADK and low-grade non-intestinal ADK.
• Adjuvant radiotherapy is considered for specific pT2/pT3 intestinal ADK cases.
• Definitive treatment for advanced stages (T4 intestinal ADK, high-grade non-intestinal ADK) involves resection and radiotherapy.
• Prophylactic cervical lymph node treatment is not advised for N0 sinonasal ADK.

Conclusions:

• The updated recommendations provide specific guidance for sinonasal adenocarcinoma.
• These guidelines aim to optimize treatment strategies for patients with this histology.