Objective: Comprehensively analyze tumor control and treatment complications for jugular paraganglioma patients undergoing surgery versus stereotactic radiosurgery (SRS)
Data Sources and Study Selection: EMBASE, Medline, and Scopus were searched for English and Spanish manuscripts from 1/1/1995-1/1/2019 for studies reporting tumor control and treatment side effects regarding patients with jugular paraganglioma treated with surgery or SRS.
Main Outcome Measures: Short-term and long-term tumor recurrence, and post-intervention complications
Data Synthesis, and Results: We identified 10,952 original abstracts, 705 eligible studies, and 107 studies for final data extraction. There were 3,498 patients—2,215 surgical patients and 1,283 SRS patients. Bayesian meta-analysis was applied to the extracted data, with tau measurements for study heterogeneity. SRS tumors were larger (3.9 cm3 vs 8.1 cm3). Metaanalysis results demonstrated low rates of long-term recurrence for both modalities (surgery: 15% recurrence, SRS: 7%), with SRS demonstrating lower rates of post-intervention CSF leak, dysphagia, and Vll, lX, X, Xl, or Xll palsies.
Conclusions: This is the largest analysis of jugular paraganglioma treatment with surgery or SRS. It demonstrates excellent tumor control by both modalities, and lower intervention morbidities with SRS for many complications.
Professional Practice Gap & Educational Need: Provide an updated systematic review and meta-analysis for surgical versus SRS treatment of jugular paraganglioma.
Learning Objective: Provide high level evidence regarding outcomes and complications for surgical and SRS treatment of jugular paragangliomas.
Desired Result:Analysis of tumor control and outcomes for treatment of jugular paragangliomas substantiated by a large systematic review and meta-analysis.