Evidence map›Paper›PMID 40400377›Full record

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

Margins in oncologic nasopharyngeal surgery: a systematic review with meta-analysis.

Antonio Daloiso, Piergiorgio Gaudioso, Alessandro Vinciguerra, Stefano Taboni, Paolo Castelnuovo, Piero Nicolai, Mario Turri-Zanoni, Marco Ferrari, Paolo Battaglia

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 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. 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

9 authors.

Antonio DaloisoSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience (DNS), University of Padua, Padua, Italy.
Piergiorgio GaudiosoSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience (DNS), University of Padua, Padua, Italy.
Alessandro VinciguerraDivision of Otorhinolaryngology, Department of Biotechnology and LifeSciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Stefano TaboniSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience (DNS), University of Padua, Padua, Italy.
Paolo CastelnuovoDivision of Otorhinolaryngology, Department of Biotechnology and LifeSciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Piero NicolaiSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience (DNS), University of Padua, Padua, Italy.
Mario Turri-ZanoniDivision of Otorhinolaryngology, Department of Biotechnology and LifeSciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Marco FerrariSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience (DNS), University of Padua, Padua, Italy.
Paolo BattagliaDivision of Otorhinolaryngology, Department of Biotechnology and LifeSciences, 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: Nasopharyngeal malignancies are rare heterogenous histologies (nasopharyngeal carcinoma [NPC], minor salivary glands carcinomas, and low-grade papillary nasopharyngeal adenocarcinoma) and a significant proportion of patients experience loco-regional recurrence after primary treatment. Resection margin status is a key prognostic factor that influences recurrence and survival, although definitions and criteria for negative, close, and positive margins remain inconsistent. This systematic review with meta-analysis aimed to summarise the existing definitions of resection margins in the literature and evaluate their impact on clinical outcomes in patients undergoing nasopharyngectomy with a specific focus on NPC. Methods: A systematic literature review was conducted according to PRISMA guidelines. Electronic databases (Scopus, PubMed, and Web of Science) were searched up to November 2024. Studies reporting on surgical margins and survival outcomes in patients with NPC treated with endoscopic or open nasopharyngectomy were included. Pooled odds ratios (OR) for overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were calculated using a random-effects model. Results: A total of 45 studies met the inclusion criteria, with 12 included in the meta-analysis. Positive surgical margins were associated with worse 5-year DFS (OR 2.21, 95% CI 1.55-3.14, p < 0.001), while no significant impact was observed on 3-year DFS (OR 2.3, p = 0.239), 3-year OS (OR 2, p = 0.167), 5-year OS (OR 2.98, p = 0.115), 3-year DSS (OR 1.25, p = 0.761), or 5-year DSS (OR 2.57, p = 0.265). Margin positivity rates were 16.9% for endoscopically-treated NPC, 20.6% for open-surgery NPC, and 20.6% for mixed histology, with no significant difference between surgical approaches (p = 0.995). Conclusions: Positive resection margins significantly impact DFS in recurrent NPC. Standardised margin definitions are needed to improve prognostication and guide decisions on adjuvant therapy.

Indexed as

Margins of ExcisionNasopharyngeal CarcinomaNasopharyngeal NeoplasmsHumansendoscopic surgerynasopharyngeal cancernasopharyngectomysurgical marginsurvival outcome

Identifiers

PMID40400377
PMCPMC12115408

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.