Craniofacial surgery for malignant skull base tumors
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Open Access
- 8 August 2003
- Vol. 98 (6), 1179-1187
- https://doi.org/10.1002/cncr.11630
Abstract
BACKGROUND Malignant tumors of the skull base are rare. Therefore, no single center treats enough patients to accumulate significant numbers for meaningful analysis of outcomes after craniofacial surgery (CFS). The current report was based on a large cohort that was analyzed retrospectively by an International Collaborative Study Group. METHODS One thousand three hundred seven patients who underwent CFS in 17 institutions were analyzable for outcome. The median age was 54 years (range, 1–98 years). Definitive treatment prior to CFS had been administered in 59% of patients and included radiotherapy in 367 patients (28%), chemotherapy in 151 patients (12%), and surgery in 523 patients (40%). The majority of tumors (87%) involved the anterior cranial fossa. Squamous cell carcinoma (29%) and adenocarcinoma (16%) were the most common histologic types. The margins of surgical resection were reported close/positive in 412 patients (32%). Adjuvant postoperative radiotherapy was received by 510 patients (39%), and chemotherapy was received by 57 patients (4%). RESULTS Postoperative complications were reported in 433 patients (33%), with local wound complications the most common (18%). The postoperative mortality rate was 4%. With a median follow‐up of 25 months, the 5‐year overall, disease‐specific, and recurrence‐free survival rates were 54%, 60%, and 53%, respectively. The histology of the primary tumor, its intracranial extent, and the status of surgical margins were independent predictors of overall, disease‐specific, and recurrence‐free survival on multivariate analysis. CONCLUSIONS CFS is a safe and effective treatment option for patients with malignant tumors of the skull base. The histology of the primary tumor, its intracranial extent, and the status of surgical margins are independent determinants of outcome. Cancer 2003;98:1179–87. © 2003 American Cancer Society. DOI 10.1002/cncr.11630Keywords
This publication has 20 references indexed in Scilit:
- Microvascular Free Tissue Transfer in Reconstructing Skull Base Defects: Lessons LearnedThe Laryngoscope, 2002
- Anterior cranial base reconstruction using free tissue transfer: Changing trendsHead & Neck, 2002
- Free tissue transfer and local flap complications in anterior and anterolateral skull base surgeryHead & Neck, 2002
- Combined Anterior Craniofacial Resection for Tumors Involving the Cribriform Plate: Early Postoperative Complications and Technical ConsiderationsNeurosurgery, 2000
- Complications in Skull Base Surgery for MalignancyThe Laryngoscope, 1999
- Results and prognostic factors in skull base surgeryThe American Journal of Surgery, 1994
- Craniofacial resection at the university of Virginia (1976‐1992): Survival analysisHead & Neck, 1994
- Management of Unresectable Malignant Tumors at the Skull Base Using Concomitant Chemotherapy and Radiotherapy with Accelerated FractionationJournal of Neurological Surgery Part B: Skull Base, 1994
- Tumors of the skull base: Outcome and survival analysis of 77 casesHead & Neck, 1994
- Craniofacial resections for tumors involving the base of the skullThe American Journal of Surgery, 1987