Maghami Ellie G, Talbot Simon G, Patel Snehal G, Singh Bhuvanesh, Polluri Ashok, Bridger Patrick G, Cantu Giulio, Cheesman Anthony D, De Sa Geraldo, Donald Paul, dos Santos Luiz R M, Fliss Dan, Gullane Patrick, Janecka Ivo, Kamata Shin-Etsu, Kowalski Luiz P, Kraus Dennis H, Levine Paul A, Pradhan Sultan, Schramm Victor, Snyderman Carl, Wei William I, Shah Jatin P
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Head Neck. 2007 Dec;29(12):1136-43. doi: 10.1002/hed.20656.
This study examined the efficacy of craniofacial surgery (CFS) in treating locally advanced nonmelanoma skin cancer (NMSC).
One hundred twenty patients who underwent CFS for NMSC were identified from 17 participating institutions. Patient, tumor, and treatment information was analyzed for prognostic impact on survival.
Surgical margins were negative in 74%, close in 3%, and involved in 23% of patients. Complications occurred in 35% of patients, half of which were local wound problems. Operative mortality was 4%. Median follow-up interval after CFS was 27 months. The 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates were 64%, 75%, and 60%, respectively. Squamous cell histology, brain invasion, and positive resection margins independently predicted worse OS, DSS, and RFS.
CFS is an effective treatment for patients with NMSC invading the skull base. Histology, extent of disease, and resection margins are the most significant predictors of outcome.
本研究探讨了颅面外科手术（CFS）治疗局部晚期非黑色素瘤皮肤癌（NMSC）的疗效。
从17个参与机构中确定了120例行CFS治疗NMSC的患者。分析患者、肿瘤和治疗信息对生存的预后影响。
74%的患者手术切缘阴性，3%切缘接近，23%切缘受累。35%的患者发生并发症，其中一半为局部伤口问题。手术死亡率为4%。CFS后的中位随访间隔为27个月。5年总生存率（OS）、疾病特异性生存率（DSS）和无复发生存率（RFS）分别为64%、75%和60%。鳞状细胞组织学、脑侵犯和阳性切缘独立预测OS、DSS和RFS较差。
CFS是治疗侵犯颅底的NMSC患者的有效方法。组织学、疾病范围和切缘是结果的最重要预测因素。
