Anterior skull base surgery for malignant tumors: a multivariate analysis of 27 years of experience.
BACKGROUND
Few studies have examined prognostic factors that have an impact on outcomes in anterior skull base surgery by multivariate analysis.


METHODS
We retrospectively examined our institution's skull base experience from 1973-2000.


RESULTS
During this time, 166 patients underwent an anterior skull base resection for malignancy (median age, 53 years; range, 6-92 years). The 5-year relapse-free and disease-specific survival was 41% and 57% (median follow-up, 53 months). Multivariate analysis found that dural invasion, primary histologic diagnosis, and margin status had a significant impact on relapse-free and disease-specific survival.


CONCLUSIONS
These data indicate that patients with anterior skull base malignancies are treated successfully with skull base surgery. Patients demonstrating adverse prognostic variables such as dural invasion, adverse histologic findings, and/or positive margins should be considered for the addition of adjuvant therapy or innovative therapies as they become available in the future.
Bentz
Brandon G
BG
Head & Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, New York 10021, USA.
Bilsky
Mark H
MH
Shah
Jatin P
JP
Kraus
Dennis
D
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D002648:Child; D004388:Dura Mater / Q000473:pathology; D018304:Esthesioneuroblastoma, Olfactory / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009296:Nasal Cavity / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis