Brunner Markus, Ch'ng Sydney, Shannon Kerwin, Clifford Anthony, Ashford Bruce, Elliott Michael, Clark Jonathan R
Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.
J Surg Oncol. 2017 Sep;116(4):545-549. doi: 10.1002/jso.24693. Epub 2017 Jun 19.
The aim of this study is to analyze the clinical outcomes of patients who underwent bone resection for cutaneous malignancy of the face and scalp.
We retrospectively collected patient data from 62 patients who underwent bone resection for craniofacial cutaneous malignancy of the face and scalp over the last 10 years. We investigated risk factors for disease progression and assessed the utility of pre-operative imaging to predict bone, dura, and brain infiltration.
Out of all factors analyzed, brain invasion, surgical margin involvement, and dural margin involvement were found to significantly reduce survival. CT and MRI correctly predicted bone infiltration in 88% and 89% of cases. MRI correctly predicted dura invasion in 89% but grossly underestimated the amount of dural invasion in 23% of reports.
Our data indicate that the resection of bone is a reasonable surgical option in the treatment of patients with advanced cutaneous malignancies of the face and scalp. Brain invasion and positive margins reduced the probability of survival.
本研究旨在分析因面部和头皮皮肤恶性肿瘤而接受骨切除的患者的临床结局。
我们回顾性收集了过去10年中62例因面部和头皮颅面部皮肤恶性肿瘤而接受骨切除的患者的数据。我们调查了疾病进展的危险因素，并评估了术前影像学检查对预测骨、硬脑膜和脑浸润的效用。
在所有分析的因素中，发现脑侵犯、手术切缘受累和硬脑膜切缘受累会显著降低生存率。CT和MRI分别在88%和89%的病例中正确预测了骨浸润。MRI在89%的病例中正确预测了硬脑膜侵犯，但在23%的报告中严重低估了硬脑膜侵犯的程度。
我们的数据表明，骨切除是治疗晚期面部和头皮皮肤恶性肿瘤患者的合理手术选择。脑侵犯和切缘阳性降低了生存概率。
