Endoscopic Versus Open Surgery in the Management of Sinonasal Glomangiopericytoma: A Systematic Review.

Abstract

Sinonasal glomangiopericytoma (GPC) is a rare vascular tumor mainly treated by surgical resection. However, the effectiveness between endoscopic and open approaches remains unclear. Hence, this systematic review addresses the PICO question: "In patients with sinonasal GPC (P), how does endoscopic resection (I) compare to open resection (C) in achieving clear surgical margins and reducing recurrence rates (O)?" A literature search was conducted on PubMed, Embase, The Cochrane Library, CINAHL and Web of Science on September 10, 2025. Studies were included if they involved patients with sinonasal GPC (Population) undergoing endoscopic (Intervention) or open (Comparison) surgical resection. Data extracted included patient demographics, staging, postresection margin status, use of adjunctive therapies, follow-up duration and recurrence outcomes (Outcomes). Out of 271 articles, 54 articles met the inclusion criteria, with a total of 78 patients. The endoscopic resection group had a significantly shorter mean follow-up duration compared to the open resection group (26.3 vs. 65.7 months, p < 0.001). There was no statistically significant difference between groups in the rate of positive resection margins (8.1% vs. 25.0%, p = 0.148) or recurrence rates (7.1% vs. 18.2%, p = 0.212). Our study found that the main determinant for approach is tumor stage and location. Endoscopic resection is favored for early-stage tumors (T1 and selected T2 lesions) due to its minimally invasive approach and favorable outcomes. Despite these observed differences in margins and recurrence, statistical significance was not reached, emphasizing caution in interpretation due to small sample sizes and potential biases.