title: Craniofacial Resection for T4 Maxillary Sinus Carcinoma: Managing Cases with Involvement of the Skull Base.
abstract: 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.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary university hospital.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan naokin@med.nagoya-u.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Nishio
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Masazumi
authors.initials: M
authors.lastname: Fujii
authors.affiliation: Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hiramatsu
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruo
authors.affiliation: Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Iwami
authors.affiliation: Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kamei
authors.affiliation: Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Shunjiro
authors.initials: S
authors.lastname: Yagi
authors.affiliation: Department of Otorhinolaryngology, Kariya General Hospital, Aichi, Japan.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Information & Communications, Nagoya University, Nagoya, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Otorhinolaryngology, Japan Labor Health, and Welfare, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ando
authors.affiliation: Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000473:pathology; D018277:Carcinoma, Mucoepidermoid / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002426:Cavernous Sinus / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology*; D016896:Treatment Outcome
keywords: cavernous sinus; craniofacial resection; maxillary sinus carcinoma; skull base; surgical strategy