Craniofacial resection for malignant tumors of the paranasal sinuses.

OBJECTIVE

To review the experience with craniofacial resection for malignant tumors of the anterior skull base and analyze prognostic factors for survival.

MATERIAL AND METHODS

Between 1996 and 2008, 64 consecutive patients with malignant tumors of the anterior skull base underwent craniofacial resection. Different parameters were analyzed to study their relationship with survival: age, sex, pathology, orbital involvement, dural involvement, status of the surgical margins, adjuvant radiotherapy, and whether the treatment was done before or after surgery. Survival analysis was carried out with the Kaplan-Meier product limit method and comparison between groups was performed by the log-rank test. Factors identified in the univariate analysis were then entered in the multivariate analysis using the Cox regression model in order to identify predictive factors of survival.

RESULTS

For the entire group survival rates were 47% at 5 years. The highest survival was observed in patients with estesioneuroblastoma and the lowest in melanoma cases. Dural involvement and orbital clearance are predictors of poor survival.

CONCLUSION

The improved survival and minimal morbidity associated with craniofacial resection make it the approach of choice for anterior skull base tumors.