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The Natural History of Residual and Recurrent Disease in Advanced Juvenile Nasopharyngeal Angiofibroma: A Systematic Review.

Shivani Angelique Kumar·Peter Petocz·Raewyn G Campbell
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Abstract

OBJECTIVE: This systematic review explores the natural history of residual and recurrent juvenile nasopharyngeal angiofibromas (JNAs) to inform clinical decision-making. DATA SOURCES: PubMed, Embase, Scopus, and Web of Science. REVIEW METHODS: A systematic literature review was conducted according to PRISMA guidelines across PubMed, Embase, Scopus, and Web of Science from inception to February 20, 2025 and was re-run on September 21, 2025. Studies included patients with advanced JNA and documented follow-up of residual or recurrent disease. Descriptive statistics, chi-squared analysis, and analysis of variance were used to evaluate treatment outcomes across different modalities including surgery, radiotherapy, gamma knife surgery, and medical therapies. RESULTS: Twenty-one studies encompassing 131 male patients (mean age 16.3 years) were included. Residual or recurrent disease demonstrated complete involution in 41%, stable disease in 29%, and reduction in size in 25% of cases. Only 2% of patients had progressive disease. A statistically significant association was observed between treatment modality and outcome (p = 0.015), with radiotherapy, either alone, or as part of a multimodal approach, showing the highest rates of spontaneous involution. CONCLUSION: Residual and recurrent JNAs often remain stable or regress without further intervention. Close surveillance with imaging is a safe and effective strategy for asymptomatic patients, minimizing the risks of additional treatment in a young patient population with disease near critical anatomical structures.

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HumansNasopharyngeal NeoplasmsAngiofibromaNeoplasm Recurrence, LocalNeoplasm, ResidualMaleAdolescentDisease ProgressionTreatment OutcomeCombined Modality Therapyadvance diseasejuvenile nasopharyngeal angiofibromamanagementSystematic ReviewJournal ArticleReview

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Shivani Angelique Kumar, Peter Petocz, Raewyn G Campbell. 2026-05-24. The Natural History of Residual and Recurrent Disease in Advanced Juvenile Nasopharyngeal Angiofibroma: A Systematic Review.. https://doi.org/10.1002/lary.70634

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Adolescent subjectCombined Modality Therapy subjectHumans subjectJournal Article subjectMale subjectSystematic Review; Journal Article; Review resourceSystematic reviews studydisease progression subjectmanagement subject

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