PDF(Pubmed)
Abstract：
Objectives Malignant tumors of the sinonasal cavities with extension to the frontal skull base are rare and challenging pathologies. Combined-approach surgery using a frontobasal craniotomy and endoscopic sinus surgery with reconstruction of the anterior skull base followed by adjuvant radiotherapy is a preferred treatment strategy in selected cases. Morbidity and mortality rates are high in this population. We aim to add our experience to the current literature. Design We performed a retrospective cross-sectional single center study of the long-term clinical outcome in a tertiary university referral hospital in the Netherlands between 2010 and 2021. Descriptive statistics and frequency distributions were performed Participants Patient, tumor, treatment, complications and survival characteristics of eighteen consecutive patients were extracted from the electronic health records. Main Outcome Measures The primary outcome measures are progression free survival, overall survival and complication rate. Results Eighteen consecutive patients were included with a mean age of 61 (SD ± 10) years (range 38-80); ten males and eight females. Gross total resection was achieved in 14 (77%) patients. Eleven (61%) patients underwent local radiotherapy, one (5%) chemotherapy and three (17%) a combination of both. Mean follow-up duration was 49 months (range 3 - 138). Three (17%) patients died in hospital due to post-operative complications. Six (33%) patients died during follow-up due to disease progression. Mean progression-free survival was 47 months (range 0 - 113). Conclusion In conclusion, the overall survival was 50% for this group of patients with large sinonasal tumors. Progressive disease affects survival rate severely. Surgical complications were seen in five (28%) patients. Radiotherapy is associated with high complication rates. Radiation necrosis was a serious complication in two patients and could be treated with high dose steroids.
摘要：
目的鼻窦腔的恶性肿瘤延伸至额颅底是罕见且具有挑战性的病理。在某些情况下，采用额基底开颅手术和内窥镜鼻窦手术并重建前颅底，然后进行辅助放疗的联合入路手术是首选的治疗策略。该人群的发病率和死亡率很高。我们的目标是将我们的经验添加到当前的文献中。设计我们在2010年至2021年间在荷兰的一所三级大学转诊医院对长期临床结果进行了回顾性横断面单中心研究。进行描述性统计和频率分布参与者，肿瘤，治疗,从电子健康记录中提取了18例连续患者的并发症和生存特征.主要结局指标主要结局指标是无进展生存期，总生存率和并发症发生率。结果共纳入18例患者，平均年龄61（SD±10）岁（范围38-80）；男性10例，女性8例。14例（77％）患者实现了总切除。11例（61%）患者接受了局部放疗，一种（5％）化疗和三种（17％）两者的组合。平均随访时间为49个月（范围3-138）。三名（17％）患者因术后并发症在医院死亡。6名（33%）患者在随访期间因疾病进展而死亡。平均无进展生存期为47个月（范围0-113）。结论总之,该组患有大型鼻腔鼻窦肿瘤的患者的总生存率为50%.进行性疾病严重影响生存率。5例（28％）患者出现手术并发症。放射治疗与高并发症发生率相关。放射性坏死是两名患者的严重并发症，可以用大剂量类固醇治疗。
