Craniofacial resection for malignant paranasal sinus tumors: 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. M.; Gullane, P.; Janecka, I.; Kamata, S. E.; Kowalski, L. P.; Levine, P. A.; Medina Dos Santos, L. R.; Pradhan, S.; Schramm, V.; Snyderman, C.; Wei, W. I.; Shah, J. P.
Article Title:	Craniofacial resection for malignant paranasal sinus tumors: Report of an international collaborative study
Abstract:	Background. Malignant tumors of the superior sinonasal vault are rare, and, because of this and the varied histologic findings, most outcomes data reflect the experience of small patient cohorts. This International Collaborative study examines a large cohort of patients accumulated from multiple institutions experienced in craniofacial surgery, with the aim of reporting benchmark figures for outcomes and identifying patient-related and tumor-related predictors of prognosis after craniofacial resection (CFR). Methods. Three hundred thirty-four patients from 17 institutions were analyzed for outcome. Patients with esthesioneuroblastoma were excluded and are being reported separately. The median age was 57 years (range, 3-98 years). One hundred eighty-eight patients (56.3%) had had prior single-modality or combined treatment, which included surgery in 120 (36%), radiation in 79 (23.7%), and chemotherapy in 56 (16.8%). The most common histologic findings were adenocarcinoma in 107 (32%) and squamous cell carcinoma in 101 (30.2%). The margins of resection were close or microscopically positive in 95 (30%). Adjuvant radiotherapy was given in 161 (48.2%) and chemotherapy in 16 (4.8%). Statistical analyses for outcomes were performed in relation to patient characteristics, tumor characteristics, including histologic findings and extent of disease surgical resection margins, prior radiation, and prior chemotherapy to determine predictive factors. Results. Postoperative mortality occurred in 15 patients (4.5%). Postoperative complications occurred in 110 patients (32.9%). The 5-year overall, disease-specific, and recurrence-free survival rates were 48.3%, 53.3%, and 45.8%, respectively The status of surgical margins, histologic findings of the primary tumor, and intracranial extent were independent predictors of overall, disease-specific, and recurrence-free survival on multivariate analysis. Conclusions. CFR for malignant paranasal sinus tumors is a safe surgical treatment with an overall mortality of 4.5% and complication rate of 33%. The status of surgical margins, histologic findings of the primary tumor, and intracranial extent are independent predictors of outcome. © 2005 Wiley Periodicals, Inc.
Keywords:	adolescent; adult; cancer survival; child; controlled study; treatment outcome; aged; aged, 80 and over; child, preschool; middle aged; survival rate; major clinical study; histopathology; cancer recurrence; squamous cell carcinoma; carcinoma, squamous cell; follow-up studies; antineoplastic agent; adenocarcinoma; cohort studies; neoplasm recurrence, local; postoperative complication; postoperative complications; infant; surgical mortality; malignant neoplastic disease; multivariate analysis; neoplasm invasiveness; skull base; paranasal sinus neoplasms; craniofacial surgery; esthesioneuroblastoma; international cooperation; paranasal sinus tumor; craniofacial resection; skull
Journal Title:	Head & Neck
Volume:	27
Issue:	7
ISSN:	1043-3074
Publisher:	John Wiley & Sons, Inc.
Date Published:	2005-07-01
Start Page:	575
End Page:	584
Language:	English
DOI:	10.1002/hed.20165
PUBMED:	15825201
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-21844436072&partnerID=40&md5=9dde37a4f58de6e9f25564b26b5277c0
Notes:	--- - "Cited By (since 1996): 66" - "Export Date: 24 October 2012" - "CODEN: HEANE" - "Source: Scopus"

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