Bentz Brandon G, Bilsky Mark H, Shah Jatin P, Kraus Dennis
Head & Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, New York 10021, USA.
Head Neck. 2003 Jul;25(7):515-20. doi: 10.1002/hed.10250.
Few studies have examined prognostic factors that have an impact on outcomes in anterior skull base surgery by multivariate analysis.
We retrospectively examined our institution's skull base experience from 1973-2000.
During this time, 166 patients underwent an anterior skull base resection for malignancy (median age, 53 years; range, 6-92 years). The 5-year relapse-free and disease-specific survival was 41% and 57% (median follow-up, 53 months). Multivariate analysis found that dural invasion, primary histologic diagnosis, and margin status had a significant impact on relapse-free and disease-specific survival.
These data indicate that patients with anterior skull base malignancies are treated successfully with skull base surgery. Patients demonstrating adverse prognostic variables such as dural invasion, adverse histologic findings, and/or positive margins should be considered for the addition of adjuvant therapy or innovative therapies as they become available in the future.
很少有研究通过多变量分析来探讨影响前颅底手术预后的因素。
我们回顾性研究了本机构1973年至2000年的颅底手术经验。
在此期间,166例患者接受了前颅底恶性肿瘤切除术(中位年龄53岁;范围6至92岁)。5年无复发生存率和疾病特异性生存率分别为41%和57%(中位随访时间53个月)。多变量分析发现,硬脑膜侵犯、原发组织学诊断和切缘状态对无复发生存率和疾病特异性生存率有显著影响。
这些数据表明,前颅底恶性肿瘤患者通过颅底手术可获得成功治疗。对于表现出不良预后变量(如硬脑膜侵犯、不良组织学发现和/或切缘阳性)的患者,应考虑在未来有可用的辅助治疗或创新治疗时加以应用。