Shah J P, Kraus D H, Bilsky M H, Gutin P H, Harrison L H, Strong E W
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Arch Otolaryngol Head Neck Surg. 1997 Dec;123(12):1312-7. doi: 10.1001/archotol.1997.01900120062010.
To review our experience with craniofacial resection for malignant neoplasms of the anterior skull base and report long-term results, and to analyze survival in terms of the overall experience, tumor histological diagnoses, and tumor extent. Also, to report complications of this surgical procedure.
Retrospective review.
Tertiary cancer facility.
We evaluated 115 consecutive patients undergoing craniofacial resection for malignant neoplasms involving the anterior skull base. Forty-five (39%) presented with recurrent or persistent disease after prior therapy.
Survival was evaluated with the Kaplan-Meier product limit method and comparisons between individual subgroups were performed using the log-rank test.
The operative mortality rate was 3.5%. Major complications occurred in 40 patients (35%). For the entire group, disease-specific survival rates were 58% and 48% at 5 and 10 years, respectively. The highest survival rate was observed in patients with esthesioneuroblastoma and lowest in those with mucosal melanoma. Survival was significantly better for those whose tumors could be excised with a limited resection in comparison with those requiring an extended procedure (P = .009).
A 23-year experience with craniofacial resection performed for malignant tumors involving the anterior skull base confirms the durable results obtained with this intervention. The diversity of histological diagnoses, site of origin, extent of tumor invasion, and impact of prior therapy hampers any attempt at reporting meaningful survival statistics for comparison with other series or other means of treatment.
回顾我们对前颅底恶性肿瘤行颅面切除术的经验并报告长期结果，根据总体经验、肿瘤组织学诊断及肿瘤范围分析生存率。同时，报告该手术的并发症。
回顾性研究。
三级癌症治疗机构。
我们评估了115例连续接受颅面切除术治疗累及前颅底恶性肿瘤的患者。其中45例（39%）在先前治疗后出现复发或持续性疾病。
采用Kaplan-Meier乘积限法评估生存率，使用对数秩检验对各亚组进行比较。
手术死亡率为3.5%。40例患者（35%）发生了严重并发症。对于整个队列，5年和10年的疾病特异性生存率分别为58%和48%。嗅神经母细胞瘤患者的生存率最高，黏膜黑色素瘤患者的生存率最低。与需要扩大手术范围的患者相比，肿瘤可通过有限切除切除的患者生存率显著更高（P = .009）。
对累及前颅底恶性肿瘤行颅面切除术23年的经验证实了该干预措施取得的持久效果。组织学诊断、起源部位、肿瘤侵犯范围的多样性以及先前治疗的影响妨碍了报告有意义的生存统计数据以与其他系列或其他治疗方法进行比较的任何尝试。
