Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Canada.
J Neurooncol. 2020 Dec;150(3):377-386. doi: 10.1007/s11060-020-03545-1. Epub 2020 Jun 5.
The purpose of this review is to assess the recent evidence regarding the management of squamous cell carcinoma of the skull-base and to discuss the implications of these findings on clinical practice.
Free text Medline and MeSH term search of publications relating to Squamous Cell Carcinoma & Skull-base and Skull base, Neoplasm respectively. Multidisciplinary clinical guidelines were also reviewed.
The primary search yielded a total of 271 papers which following initial review was reduced to 28. Secondary search yielded 56 papers. There were no randomised controlled trials relating to squamous cell carcinoma of the skull-base and as such this review is based on cohort studies, case series and expert opinion.
Squamous cell carcinoma (SCC) is the most common cancer occurring in the Head and Neck. Squamous cell carcinoma is also the most common cancer arising within the nose and sinuses of which skull-base squamous cell carcinoma is a rare subgroup. Evidence relating to the management and survival of skull-base SCC is based on expert opinion and. retrospective analyses Clinical examination and biopsy, imaging and a broad multidisciplinary team are key to the management of skull-base SCC. The information gathered should be used to guide informed discussion by suitably trained experts with patients regarding surgical approach, post-operative recovery and adjuvant or neoadjuvant treatments. The standard of care is currently to perform skull base resection with or without additional craniotomy, pedicled or free flap reconstruction in multiple layers and post-operative radiation (usually photons or protons). Open approaches have traditionally been the mainstay, however in certain cases endoscopic approaches can yield equivalent results and offer many advantages. Despite advances in care survival remains poor with a nearly one in five risk of nodal recurrence within two years.
本综述旨在评估关于颅底鳞状细胞癌管理的最新证据，并讨论这些发现对临床实践的影响。
自由文本 Medline 和 MeSH 术语搜索与鳞状细胞癌和颅底以及分别为颅底肿瘤相关的出版物。还审查了多学科临床指南。
初步搜索共产生了 271 篇论文，经过初步审查后减少到 28 篇。二次搜索产生了 56 篇论文。没有关于颅底鳞状细胞癌的随机对照试验，因此本综述基于队列研究、病例系列和专家意见。
鳞状细胞癌（SCC）是头颈部最常见的癌症。鳞状细胞癌也是鼻腔和鼻窦最常见的癌症，其中颅底鳞状细胞癌是一个罕见的亚组。与颅底 SCC 的管理和生存相关的证据基于专家意见和回顾性分析。临床检查和活检、影像学和广泛的多学科团队是颅底 SCC 管理的关键。收集的信息应用于指导经过适当培训的专家与患者就手术方法、术后恢复以及辅助或新辅助治疗进行知情讨论。目前的护理标准是进行颅底切除术，有或没有额外的开颅术、带蒂或游离皮瓣重建多层和术后放疗（通常是光子或质子）。传统上开放方法一直是主要方法，但在某些情况下，内镜方法可以产生等效的结果并提供许多优势。尽管护理有所进步，但生存率仍然很差，近五分之一的患者在两年内有淋巴结复发的风险。
