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REFCOR guidelines on the management of olfactory neuroblastoma: A formalized expert consensus.

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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.

European Annals of Otorhinolaryngology, Head and Neck Diseases
|May 9, 2026
PubMed
Summary

Updated guidelines for sinonasal adenocarcinoma (ADK) management are presented. Key recommendations include surgery for early stages and radiotherapy for advanced stages, with no prophylactic lymph node treatment for N0 disease.

Keywords:
ChemotherapyEndoscopic surgeryGuidelinesNasal cavity cancerREFCORRadiotherapySinus cancer

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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.