Craniofacial Resection for T4 Maxillary Sinus Carcinoma: Managing Cases with Involvement of the Skull Base
Craniofacial Resection for T4 Maxillary Sinus Carcinoma: Managing Cases with Involvement of the Skull Base
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DOI：
10.1177/0194599815586770
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发表时间：
2015-08-01
影响因子：
3.4
通讯作者：
Nakashima, Tsutomu
中科院分区：
文献类型：
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作者：
Nishio, Naoki;Fujimoto, Yasushi;Nakashima, Tsutomu
目的本研究的目的是澄清的结果颅面切除局部晚期上颌窦癌分类为T4和目前的方法管理的情况下，涉及skull basin.Study Design Case series with chart review.Setting Tertiary university hospital.Subjects and Methods我们进行了前外侧颅面切除术在整块时尚局部晚期上颌窦癌在T4阶段。参与者包括1992年至2011年间接受治疗的40例T4上颌窦癌患者。结果T4a期26例，T4b期14例。40例T4上颌窦癌患者的5年总生存率和无瘤生存率分别为62.7%和52.6%。海绵窦受累与预后不良显著相关（P = 0.012）。在35例无海绵窦受累的病例中，既往治疗（P = 0.017）和切缘阳性（P = 0.019）与预后不良显著相关，5年总生存率和无病生存率分别为72.4%和55.3%.Conclusion本研究仅包括局部晚期上颌窦癌T4分类的病例。考虑到晚期，我们的研究表明，在颅底恶性肿瘤的整体切除术中，处理海绵窦的重要性和相对有利的结局。颅面整块切除术获得了良好的生存率。
Objective The objective of this study was to clarify the outcomes of craniofacial resection for locally advanced maxillary sinus carcinoma classified as T4 and to present methods for managing cases involving the skull base.Study Design Case series with chart review.Setting Tertiary university hospital.Subjects and Methods We performed anterolateral craniofacial resection in en bloc fashion for locally advanced maxillary sinus carcinoma at stage T4. Participants comprised 40 patients with T4 maxillary sinus carcinoma treated between 1992 and 2011. Surgical outcomes were analyzed retrospectively.Results Forty patients with stage T4a (n = 26) or stage T4b (n = 14) were included in this study. Five-year overall and disease-free survival rates for the 40 patients with T4 maxillary sinus carcinoma were 62.7% and 52.6%, respectively. Cavernous sinus involvement correlated significantly with worse prognosis (P = .012). In 35 cases without cavernous sinus involvement, previous treatment (P = .017) and positive margins (P = .019) correlated significantly with worse prognosis, and 5-year overall and disease-free survival rates were 72.4% and 55.3%, respectively.Conclusion This study only included cases of locally advanced maxillary sinus carcinoma classified as T4. Considering the advanced stage, our study suggests relatively favorable outcomes and the importance of managing the cavernous sinus in en bloc resections of malignant skull base tumors. Craniofacial resection in en bloc fashion achieved good survival rates.