title: Improvement in survival during the past 4 decades among patients with anterior skull base cancer.
abstract: BACKGROUND
  The aims of this study were to determine the trends in survival of patients with anterior skull base cancer over several decades and to identify time-related changes in the demographic and clinical characteristics of this population.
  
  
  METHODS
  In all, 282 patients who underwent craniofacial resection at Memorial Sloan-Kettering Cancer Center and Tel Aviv Medical Center were studied. Patients were categorized in accord with the period of surgery: early (1973-1984, n = 34), intermediate (1985-1996, n = 72), and later (1997-2008, n = 176).
  
  
  RESULTS
  Patients operated after 1996 had higher rates of comorbidity, dural and pterygopalatine invasion, and multicompartmental involvement than those operated before 1996 (p ≤ .001). There was a significant improvement in 5-year overall and disease-specific survival, from 55% and 57%, respectively, for patients operated before 1996, to 66% and 70%, respectively, for those operated after 1996 (p = .02 and p = .006, respectively). On multivariate analysis, surgery after 1996 was an independent predictor of outcome (HR, 0.39, p < .001).
  
  
  CONCLUSIONS
  The survival of patients with anterior skull base cancer is improving. Surgery after 1996 is an independent prognostic factor for an improved outcome.
authors.affiliation: The Head and Neck Surgery Unit, Department of Otolaryngology Head and Neck Surgery, Tel Aviv Souraky Medical Center, Tel Aviv, Israel. ziv@baseofskull.org
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
authors.forename: Oren
authors.initials: O
authors.lastname: Cavel
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology* / Q000601:surgery; D019292:Skull Base Neoplasms / Q000401:mortality* / Q000601:surgery; D055815:Young Adult