Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes

dc.contributor.authorQedair, Jumanah
dc.contributor.authorHaider, Ali S.
dc.contributor.authorBalasubramanian, Kishore
dc.contributor.authorPalmisciano, Paolo
dc.contributor.authorHassan, Taimur
dc.contributor.authorShahbandi, Ataollah
dc.contributor.authorSabahi, Mohammadmahdi
dc.contributor.authorKharbat, Abdurrahman F.
dc.contributor.authorAbou-Al-Shaar, Hussam
dc.contributor.authorYu, Kenny
dc.contributor.authorCohen-Gadol, Aaron A.
dc.contributor.authorEl Ahmadieh, Tarek Y.
dc.contributor.authorBin-Alamer, Othman
dc.contributor.departmentNeurological Surgery, School of Medicine
dc.date.accessioned2024-03-11T12:02:45Z
dc.date.available2024-03-11T12:02:45Z
dc.date.issued2023-08-27
dc.description.abstractBackground: The outcomes of orbital exenteration (OE) in patients with craniofacial lesions (CFLs) remain unclear. The present review summarizes the available literature on the clinical outcomes of OE, including surgical outcomes and overall survival (OS). Methods: Relevant articles were retrieved from Medline, Scopus, and Cochrane according to PRISMA guidelines. A systematic review and meta-analysis were conducted on the clinical characteristics, management, and outcomes. Results: A total of 33 articles containing 957 patients who underwent OE for CFLs were included (weighted mean age: 64.3 years [95% CI: 59.9-68.7]; 58.3% were male). The most common lesion was squamous cell carcinoma (31.8%), and the most common symptom was disturbed vision/reduced visual acuity (22.5%). Of the patients, 302 (31.6%) had total OE, 248 (26.0%) had extended OE, and 87 (9.0%) had subtotal OE. Free flaps (33.3%), endosseous implants (22.8%), and split-thickness skin grafts (17.2%) were the most used reconstructive methods. Sino-orbital or sino-nasal fistula (22.6%), flap or graft failure (16.9%), and hyperostosis (13%) were the most reported complications. Regarding tumor recurrences, 38.6% were local, 32.3% were distant, and 6.7% were regional. The perineural invasion rate was 17.4%, while the lymphovascular invasion rate was 5.0%. Over a weighted mean follow-up period of 23.6 months (95% CI: 13.8-33.4), a weighted overall mortality rate of 39% (95% CI: 28-50%) was observed. The 5-year OS rate was 50% (median: 61 months [95% CI: 46-83]). The OS multivariable analysis did not show any significant findings. Conclusions: Although OE is a disfiguring procedure with devastating outcomes, it is a viable option for carefully selected patients with advanced CFLs. A patient-tailored approach based on tumor pathology, extension, and overall patient condition is warranted.
dc.eprint.versionFinal published version
dc.identifier.citationQedair J, Haider AS, Balasubramanian K, et al. Orbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes. Cancers (Basel). 2023;15(17):4285. Published 2023 Aug 27. doi:10.3390/cancers15174285
dc.identifier.urihttps://hdl.handle.net/1805/39147
dc.language.isoen_US
dc.publisherMDPI
dc.relation.isversionof10.3390/cancers15174285
dc.relation.journalCancers
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourcePMC
dc.subjectCarcinoma
dc.subjectCraniofacial
dc.subjectMeta-analysis
dc.subjectOrbital exenteration
dc.subjectOutcomes
dc.subjectSurvival
dc.subjectSystematic review
dc.titleOrbital Exenteration for Craniofacial Lesions: A Systematic Review and Meta-Analysis of Patient Characteristics and Survival Outcomes
dc.typeArticle
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
cancers-15-04285.pdf
Size:
2.73 MB
Format:
Adobe Portable Document Format
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.99 KB
Format:
Item-specific license agreed upon to submission
Description: