涉及颅底的儿童和青少年恶性肿瘤患者的颅面外科手术结果：一项国际合作研究。

Outcome of craniofacial surgery in children and adolescents with malignant tumors involving the skull base: an international collaborative study.

作者信息

Gil Ziv, Patel Snehal G, Cantu Giulio, Fliss Dan M, Kowalski Luiz P, Singh Bhuvanesh, Snyderman Carl, Kraus Dennis H, Shah Jatin P, Bridger Patrick G, Cheesman Anthony D, Donald Paul, Gullane Patrick, Janecka Ivo, Kamata Shin-etsu, Levine Paul A, Medina Luiz R, Pradhan Sultan, Schramm Victor, Wei William I

机构信息

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

出版信息

Head Neck. 2009 Mar;31(3):308-17. doi: 10.1002/hed.20958.

DOI:10.1002/hed.20958

PMID:19073003

Abstract

BACKGROUND

The aim of the study was to characterize the distribution of anterior skull base (ASB) cancers in the pediatric population and to identify predictors of outcome.

METHODS

This was an international study of 1307 patients undergoing craniofacial surgery for malignant tumors; 6.4% (n = 84) among these were <or=21 years old.

RESULTS

The most common histologic type was sarcoma (40%), followed by squamous cell carcinoma (14%). Higher incidence of tumors was found in older children (7.5-21 years) compared to younger children. The 5-year disease-specific and overall survival rates were 61% and 55%, respectively (median follow-up of 30 months). The best prognosis was associated with low-grade sarcomas and the worst with salivary and squamous cell carcinomas. High-grade sarcoma represented an intermediate risk group. On multivariate analysis, prior radiotherapy and histology were independent predictors of survival.

CONCLUSION

Surgery for malignant tumors involving the ASB is feasible and safe in children. Histology is significant determinant of poor outcome in this population.

摘要

背景

本研究旨在描述小儿人群前颅底（ASB）癌症的分布情况，并确定预后的预测因素。

方法

这是一项针对1307例因恶性肿瘤接受颅面手术患者的国际研究；其中6.4%（n = 84）年龄小于或等于21岁。

结果

最常见的组织学类型是肉瘤（40%），其次是鳞状细胞癌（14%）。与年幼儿童相比，年龄较大儿童（7.5 - 21岁）的肿瘤发病率更高。5年疾病特异性生存率和总生存率分别为61%和55%（中位随访30个月）。预后最好的是低级别肉瘤，最差的是唾液腺癌和鳞状细胞癌。高级别肉瘤代表中等风险组。多因素分析显示，既往放疗和组织学是生存的独立预测因素。