Background: 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.
背景：对于颅面部病变（CFLs）患者，眼眶内容物剜除术（OE）的预后尚不明确。本综述旨在总结现有关于OE临床结局的文献，包括手术结果和总生存期（OS）。方法：根据PRISMA指南，从Medline、Scopus和Cochrane数据库中检索相关文献。对临床特征、治疗方式及结局进行了系统综述和荟萃分析。结果：共纳入33篇文献，涉及957例因CFLs接受OE的患者（加权平均年龄：64.3岁[95% CI: 59.9–68.7]；男性占58.3%）。最常见的病变为鳞状细胞癌（31.8%），最常见症状为视力障碍/视力下降（22.5%）。患者中，302例（31.6%）接受全OE，248例（26.0%）接受扩大OE，87例（9.0%）接受次全OE。最常用的重建方法为游离皮瓣（33.3%）、骨内种植体（22.8%）和分层皮片移植（17.2%）。最常见的并发症为鼻眶或鼻窦瘘（22.6%）、皮瓣或移植物失败（16.9%）和骨质增生（13%）。肿瘤复发方面，局部复发占38.6%，远处转移占32.3%，区域复发占6.7%。神经侵犯率为17.4%，淋巴血管侵犯率为5.0%。在加权平均随访23.6个月（95% CI: 13.8–33.4）期间，加权总死亡率为39%（95% CI: 28–50%）。5年OS率为50%（中位生存期：61个月[95% CI: 46–83]）。OS多变量分析未显示显著相关因素。结论：尽管OE是一种会导致毁容且预后不良的手术，但对于经过严格筛选的晚期CFLs患者，仍是一种可行的治疗选择。建议根据肿瘤病理学特征、侵犯范围及患者整体状况，采取个体化治疗方案。
肿瘤(癌症)患者之家