Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2021 Aug 10;55(3):323-332. doi: 10.2478/raon-2021-0012.
The aim of the study was to identify the value of extensive resection and reconstruction with flaps in the treatment of locoregionally advanced lateral skull-base cancer.
The retrospective case review of patients with lateral skull-base cancer treated surgically with curative intent between 2011 and 2019 at a tertiary otorhinolaryngology referral centre was made.
Twelve patients with locoregionally advanced cancer were analysed. Lateral temporal bone resection was performed in nine (75.0%), partial parotidectomy in six (50.0%), total parotidectomy in one (8.3%), ipsilateral selective neck dissection in eight (66.7%) and ipsilateral modified radical neck dissection in one patient (8.3%). The defect was reconstructed with anterolateral thigh free flap, radial forearm free flap or myocutaneous flap in two patients (17.0%) each. Mean overall survival was 3.1 years (SD = 2.5) and cancer-free survival rate 100%. At the data collection cut-off, 83% of analysed patients and 100% of patients with flap reconstruction were alive.
Favourable local control in lateral skull-base cancer, which mainly involves temporal bone is achieved with an extensive locoregional resection followed by free or regional flap reconstruction. Universal cancer registry should be considered in centres treating this rare disease to alleviate analysis and multicentric research.
本研究旨在探讨广泛切除和皮瓣重建在局部晚期侧颅底癌症治疗中的价值。
回顾性分析了 2011 年至 2019 年在一家三级耳鼻喉科转诊中心接受根治性手术治疗的侧颅底癌症患者。
分析了 12 例局部晚期癌症患者。9 例（75.0%）行颞骨外侧切除术，6 例（50.0%）行腮腺部分切除术，1 例（8.3%）行腮腺全切除术，8 例（66.7%）行同侧选择性颈淋巴结清扫术，1 例（8.3%）行同侧改良根治性颈淋巴结清扫术。2 例（17.0%）患者采用股前外侧游离皮瓣、桡侧游离皮瓣或肌皮瓣重建。总的中位生存时间为 3.1 年（标准差=2.5），无癌症生存率为 100%。在数据收集截止时，83%的分析患者和 100%的皮瓣重建患者存活。
广泛的局部区域切除后，采用游离或区域性皮瓣重建，可实现局部晚期侧颅底癌症（主要涉及颞骨）的良好局部控制。治疗这种罕见疾病的中心应考虑建立癌症通用登记处，以减轻分析和多中心研究的负担。
