title: Outcome of craniofacial surgery in children and adolescents with malignant tumors involving the skull base: an international collaborative study.
abstract: BACKGROUND
  The aim of the study was to characterize the distribution of anterior skull base (ASB) cancers in the pediatric population and to identify predictors of outcome.
  
  
  METHODS
  This was an international study of 1307 patients undergoing craniofacial surgery for malignant tumors; 6.4% (n = 84) among these were <or=21 years old.
  
  
  RESULTS
  The most common histologic type was sarcoma (40%), followed by squamous cell carcinoma (14%). Higher incidence of tumors was found in older children (7.5-21 years) compared to younger children. The 5-year disease-specific and overall survival rates were 61% and 55%, respectively (median follow-up of 30 months). The best prognosis was associated with low-grade sarcomas and the worst with salivary and squamous cell carcinomas. High-grade sarcoma represented an intermediate risk group. On multivariate analysis, prior radiotherapy and histology were independent predictors of survival.
  
  
  CONCLUSIONS
  Surgery for malignant tumors involving the ASB is feasible and safe in children. Histology is significant determinant of poor outcome in this population.
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA. ziv@baseofskull.org
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.forename: Giulio
authors.initials: G
authors.lastname: Cantu
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
authors.forename: Luiz P
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Bhuvanesh
authors.initials: B
authors.lastname: Singh
authors.forename: Carl
authors.initials: C
authors.lastname: Snyderman
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Bridger
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Cheesman
authors.forename: Paul
authors.initials: P
authors.lastname: Donald
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
authors.forename: Ivo
authors.initials: I
authors.lastname: Janecka
authors.forename: Shin-etsu
authors.initials: SE
authors.lastname: Kamata
authors.forename: Paul A
authors.initials: PA
authors.lastname: Levine
authors.forename: Luiz R
authors.initials: LR
authors.lastname: Medina
authors.forename: Sultan
authors.initials: S
authors.lastname: Pradhan
authors.forename: Victor
authors.initials: V
authors.lastname: Schramm
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018304:Esthesioneuroblastoma, Olfactory / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D019292:Skull Base Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D015996:Survival Rate; D055815:Young Adult