Evidence map›Paper›PMID 40400376›Full record

SynthesisActa otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale2025

Surgical margin assessment and prognostic impact in sinonasal cancers: a systematic review and meta-analysis.

Alberto Daniele Arosio, Elisa Coden, Alessia Lambertoni, Giorgio Sileo, Gianluca Dalfino, Giulia Monti, Antonio Daloiso, Piergiorgio Gaudioso, Marco Ferrari, Piero Nicolai and 2 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Alberto Daniele Arosio *Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Elisa Coden *Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Alessia LambertoniUnit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Giorgio SileoUnit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Gianluca DalfinoUnit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Giulia MontiUnit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Antonio DaloisoSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy.
Piergiorgio GaudiosoSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy.
Marco FerrariSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy.
Piero NicolaiSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy.
Paolo CastelnuovoUnit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Maurizio BignamiUnit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Surgery remains a cornerstone in treatment of sinonasal malignancies, but the prognostic role of margin status is controversial. This systematic review and meta-analysis evaluated the prognostic significance of surgical margins in sinonasal cancer and their impact on survival, alongside key challenges in its evaluation. Methods: A systematic search in PubMed, Scopus, and Web of Science identified 64 studies (34,120 patients). Results: The overall margin infiltration rate was 33.2%, varying widely across studies (4.5-88.2%) and histotypes, and was the highest in adenoid cystic carcinoma (ACC, 61.5%). Meta-analysis of 31 studies showed positive margins were associated with worse survival (overall survival, odds ratio [OR] 2.61; disease-specific survival, OR 5.89; disease-free survival, OR 4.40). Squamous cell carcinoma, olfactory neuroblastoma, and mucosal melanoma had the strongest correlation with margin status, while for ACC and adenocarcinomas statistical significance was not reached. High heterogeneity was noted across studies, alongside inconsistent margin classification, distance thresholds, and use of frozen sections, limiting cross-study comparability. Conclusions: This study confirms the prognostic value of surgical margins, but underscores the urgent need for standardised definitions to improve prediction of oncologic outcomes and clinical decision-making.

Indexed as

Margins of ExcisionParanasal Sinus NeoplasmsHumansPrognosiscancermargins of excisionmeta-analysisparanasal sinus neoplasmssurvival analysis

Identifiers

PMID40400376
PMCPMC12115405

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.