Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class.

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Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class.

Clin Otolaryngol. 2017 Dec 08;:

Authors: Jansen TTG, Timmers HJLM, Marres HAM, Kaanders JHAM, Kunst HPM

Abstract
OBJECTIVE: Key for successful jugulotympanic paraganglioma management is a personalized approach aiming for the best practice for each individual patient. To this end, a systematic review is performed, evaluating the local control- and complication rates for the different treatment modalities stratified by the broadly accepted Fisch classification.
DESIGN: A systematic literature review according to the PRISMA statement was performed. A detailed overview of individual treatment outcomes per Fisch class is provided.
MAIN OUTCOME MEASURES: local control, cranial nerve damage, complications, function recovery.
RESULTS: Eighteen studies were selected, resembling 83 patients treated with radiotherapy and 299 with surgery. Excellent local control was found post surgery for class A and B tumours and risk of cranial nerve damage was <1%. For class C1-4 tumours, local control was 80-95% post surgery (84% post radiotherapy) and, cranial nerve damage was found in 71-76% (none post radiotherapy; p < 0.05). There was no difference in treatment outcomes between tumours of different C class. For class C1-4De/Di tumours, local control was 38-86% (98% post radiotherapy; p < 0.05), cranial nerve damage/complication rates were 67-100% (3% post radiotherapy; p < 0.05). C1-4DeDi tumours showed lesser local control and cranial nerve damage rates when compared to C1-4De tumours.
CONCLUSIONS: An individual risk is constituted for surgery and radiotherapy, stratified per Fisch class. For class A and B tumours surgery is a suitable treatment option. For class C and D tumours radiotherapy results in lower complication rates and similar or better local control rates when compared to the surgical group. This article is protected by copyright. All rights reserved.

PMID: 29222838 [PubMed - as supplied by publisher]

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