Prognostic significance of transdural invasion of cranial base malignancies in patients undergoing craniofacial resection.

摘要: OBJECTIVE: Invasion of the brain and/or dura is a known negative prognostic factor for patients undergoing craniofacial resection cranial base malignancy. However, an evaluation factors that may affect prognosis in this patient subgroup has not been undertaken. METHODS: Between 1993 and 2003, 212 underwent primary malignancy at University Texas M.D. Anderson Cancer Center. Twenty-eight (eight women, 20 men; median age, 52 yr; age range, 26-76 yr) had evidence transdural spread (subdural tumor or invasion) These were identified retrospective review prospectively collected data was RESULTS: Subdural tumors found 16 these patients, invasion detected 12. Gross total resections achieved 22 patients: 13 with microscopically margins, eight positive one unspecified margins. Surgical complications occurred six patients. There no surgical mortality. The 5-year actuarial overall survival (OS) 58%. Eleven disease, 1 died alive disease end follow-up period. progression-free (PFS) 38 months (95% confidence interval, 4-72 mo). margins key predictor OS PFS. Brain (significant PFS; trend only OS). shorter PFS high-grade tumors. CONCLUSION: Overall highly selected similar to what historically reported without such invasion. most important variables positively affecting seem be ability achieve margins-negative followed by absence Performing piecemeal fashion does outcomes.