Riechelmann H, Meling D, Messer P, Richter H P, Rettinger G, Antoniadis G
Univ.-HNO-Klinik, Ulm.
Laryngorhinootologie. 2006 Jun;85(6):426-34. doi: 10.1055/s-2006-925021. Epub 2006 Feb 2.
Survival and quality of life after subcranial resection of malignant tumors infiltrating the anterior skull base should be evaluated.
Data were acquired retrospectively from patient charts and by telephone interview. Quality of life was assessed with the EORTC QLQ30 and H&N35 modules.
From 1996 to 2004, 19 patients (mean age 52 years, 4 woman, 15 men) were surgically treated via a subcranial approach. Fifteen patients suffered from advanced carcinoma, 3 from advanced esthesioneuroblastoma, and 1 patient had a fibrosarcoma. Fifteen patients received adjuvant radiotherapy. During the mean follow-up period of 44 months (12-109 months), 6 patients died, 1 unrelated to the tumor. The probability to survive 5 years was 50 %, the mean survival time was 72 months. Anosmia was reported by 18 of 19 patients. A tension pneumocephalus was observed in 2 patients, one with lethal outcome, decreased vision in 1 patient, loss of vision in 1, persisting diplopia in 1, deep wound infections in 2, and CSF leak in 2 patients. Quality of life was assessed on the average 36 months following end of therapy and did not differ substantially from other patients with head-neck malignancies.
Most, malignant tumors infiltrating the anterior skull base can be treated curatively. The treatment outcome is well comparable to other head and neck tumors of corresponding stage.
应评估经颅底入路切除浸润前颅底的恶性肿瘤后的生存率和生活质量。
通过回顾患者病历和电话访谈获取数据。使用欧洲癌症研究与治疗组织（EORTC）QLQ30和H&N35模块评估生活质量。
1996年至2004年，19例患者（平均年龄52岁，4例女性，15例男性）经颅底入路接受手术治疗。15例患者患有晚期癌，3例患有晚期嗅神经母细胞瘤，1例患有纤维肉瘤。15例患者接受了辅助放疗。在平均44个月（12 - 109个月）的随访期内，6例患者死亡，1例与肿瘤无关。5年生存率为50%，平均生存时间为72个月。19例患者中有18例报告嗅觉丧失。2例患者观察到张力性气颅，1例致死；1例患者视力下降，1例失明，1例持续性复视，2例深部伤口感染，2例脑脊液漏。在治疗结束后平均36个月评估生活质量，与其他头颈恶性肿瘤患者相比无显著差异。
大多数浸润前颅底的恶性肿瘤可以治愈。治疗结果与相应分期的其他头颈肿瘤相当。
