Complications of craniofacial resection for malignant tumors of the skull base: Report of an international collaborative study Journal Article

  

Authors:	Ganly, I.; Patel, S. G.; Singh, B.; Kraus, D. H.; Bridger, P. G.; Cantu, G.; Cheesman, A.; De Sa, G.; Donald, P.; Fliss, D.; Gullane, P.; Janecka, I.; Kamata, S. E.; Kowalski, L. P.; Levine, P.; Medina, L. R.; Pradhan, S.; Schramm, V.; Snyderman, C.; Wei, W. I.; Shah, J. P.
Article Title:	Complications of craniofacial resection for malignant tumors of the skull base: Report of an international collaborative study
Abstract:	Background. Advances in imaging, surgical technique, and perioperative care have made craniofacial resection (CFR) an effective and safe option for treating malignant tumors involving the skull base. The procedure does, however, have complications. Because of the relative rarity of these tumors, most existing data on postoperative complications come from individual reports of relatively small series of patients. This international collaborative report examines a large cohort of patients accumulated from multiple institutions with the aim of identifying patient-related and tumor-related predictors of postoperative morbidity and mortality and set a benchmark for future studies. Methods. One thousand one hundred ninety-three patients from 17 institutions were analyzed for postoperative mortality and complications. Postoperative complications were classified into systemic, wound, central nervous system (CNS), and orbit. Statistical analyses were carried out in relation to patient characteristics, extent of disease, prior radiation treatment, and type of reconstruction to determine factors that predicted mortality or complications. Results. Postoperative mortality occurred in 56 patients (4.7%). The presence of medical comorbidity was the only independent predictor of mortality. Postoperative complications occurred in 433 patients (36.3%). Wound complications occurred in 237 (19.8%), CNS-related complications in 193 (16.2%), orbital complications in 20 (1.7%), and systemic complications in 57 (4.8%) patients. Medical comorbidity, prior radiation therapy, and the extent of intracranial tumour involvement were independent predictors of postoperative complications. Conclusions. CFR is a safe surgical treatment for malignant tumors of the skull base, with an overall mortality of 4.7% and complication rate of 36.3%. The impact of medical comorbidity and intracranial tumor extent should be carefully considered when planning therapy for patients whose tumors are amenable to CFR. © 2005 Wiley Periodicals, Inc.
Keywords:	adolescent; adult; child; aged; aged, 80 and over; child, preschool; middle aged; surgical technique; retrospective studies; major clinical study; combined modality therapy; risk factors; cancer therapy; postoperative complication; postoperative complications; infant; comorbidity; surgical mortality; neoplasm invasiveness; perioperative period; skull base neoplasms; craniofacial surgery; skull base tumor; international cooperation; intracranial tumor; central nervous system disease; skull base neoplasms/surgery; orbit disease
Journal Title:	Head & Neck
Volume:	27
Issue:	6
ISSN:	1043-3074
Publisher:	John Wiley & Sons, Inc.
Date Published:	2005-06-01
Start Page:	445
End Page:	451
Language:	English
DOI:	10.1002/hed.20166
PUBMED:	15825205
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-20044377428&partnerID=40&md5=9ece4a9591aca8d4de81b623de801352
Notes:	--- - "Cited By (since 1996): 73" - "Export Date: 24 October 2012" - "CODEN: HEANE" - "Source: Scopus"

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