Craniofacial resection for sinunasal tumors.

Autor: Granados-García M; Department of Head and Neck Surgery, Instituto Nacional de Cancerología, México, Tlalpan. martingranadosmx@yahoo.com.mx, Celis-López MA, Aguilar-Ponce JL, Villavicencio-Valencia V, Luna-Ortiz K, Poitevin-Chachón A, Carrillo-Hernández F, Herrera-Gómez A
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2006 Feb; Vol. 8 (2), pp. 119-23.
DOI: 10.1007/s12094-006-0168-8
Abstrakt: Introduction: Malignant sinonasal tumors are very rare in Mexico. They ussually present as advanced disease because it is extremely difficult to make an early diagnosis; in addition, its treatment is complicated by a variety of lesions. Surgical resection remains the mainstay of treatment, but its relative therapeutic value compared with alternative treatments is controversial.
Objective: We undertook a retrospective analysis in order to evaluate results of craniofacial resections for sinonasal tumors.
Materials and Methods: A total of 20 patients, 11 men and 9 women were considered, median age was 49 years (18-74). Eleven had received previous treatment elsewhere. In 13 patients tumor was limited to maxillo-ethmoid complex, but in 6 cases tumor involved anteroinferior aspect of sphenoid sinus, in 7 extended to the orbit, in 3 to dura and two to the brain. One had cervical metastases. Median tumoral size was 5.8 cm (1-10).
Results: Overall complication rate was 50%. Major surgical complications occurred in 4 patients (20%): one patient developed isolated cerebrospinal fluid leakage (CEFL), 1 developed deterioration of mental status, and two developed meningitis associated with CEFL. Late complications occurred in 30% of the patients. There was not any operative death. Eleven patients received postoperative radiotherapy. Fifteen patients recurred. There were 11 local relapses, although one associated with a regional relapse, and another with regional and distant relapse. There were four isolated regional fails and six isolated distant failures. Three year overall survival was 65%, and 3-year disease free survival was 50%. Patients without previous treatment median survival was 28.3 months, meanwhile with previous treatment was 18.2 months.
Conclusions: Craniofacial resection is a safe and valuable tool in the treatment of advanced sinonasal tumors involving cranial base.
Databáze: MEDLINE
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