Produção Nacional
Revisado por pares
Complications of craniofacial resection for malignant tumors of the skull base: Report of an International Collaborative Study
2005; Wiley; Volume: 27; Issue: 6 Linguagem: Inglês
10.1002/hed.20166
ISSN1097-0347
AutoresIan Ganly, Snehal G. Patel, Bhuvanesh Singh, Dennis H. Kraus, Patrick G. Bridger, Giulo Cantu, Anthony D. Cheesman, Geraldo De, Paul F. Donald, Dan M. Fliss, Patrick Gullane, Ivo P. Janecka, Shin-etsu Kamata, Luiz Paulo Kowalski, Paul A. Levine, Luiz Roberto Medina dos Santos, Sultan Pradhan, Victor L. Schramm, Carl H. Snyderman, WI Wei, Jatin P. Shah,
Tópico(s)Bone Tumor Diagnosis and Treatments
ResumoHead & NeckVolume 27, Issue 6 p. 445-451 Regular Article Complications of craniofacial resection for malignant tumors of the skull base: Report of an International Collaborative Study† Ian Ganly MD, PhD, Ian Ganly MD, PhD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorSnehal G. Patel MD, Snehal G. Patel MD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorBhuvanesh Singh MD, Bhuvanesh Singh MD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorDennis H. Kraus MD, Dennis H. Kraus MD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorPatrick G. Bridger MD, Patrick G. Bridger MD Prince of Wales Hospital, Sydney, AustraliaSearch for more papers by this authorGiulo Cantu MD, Giulo Cantu MD Istituto Nazionale Tumori, Milan, ItalySearch for more papers by this authorAnthony Cheesman MD, Anthony Cheesman MD The Royal National Throat, Nose and Ear Hospital, London, United KingdomSearch for more papers by this authorGeraldo De Sa MD, Geraldo De Sa MD Istituto Nacional De Cancer, Rio de Janeiro, Brazil This author is deceased.Search for more papers by this authorPaul Donald MD, Paul Donald MD University of California-Davis Medical Center, Sacramento, CaliforniaSearch for more papers by this authorDan Fliss MD, Dan Fliss MD Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelSearch for more papers by this authorPatrick Gullane MD, Patrick Gullane MD Toronto General Hospital, Toronto, Ontario, CanadaSearch for more papers by this authorIvo Janecka MD, Ivo Janecka MD Massachusetts Eye and Ear Infirmary, Boston, MassachusettsSearch for more papers by this authorShin-etsu Kamata MD, Shin-etsu Kamata MD Cancer Institute Hospital, Tokyo, JapanSearch for more papers by this authorLuiz P. Kowalski MD, Luiz P. Kowalski MD Hospital do Cancer A.C. Camargo, Sao Paulo, BrazilSearch for more papers by this authorPaul Levine MD, Paul Levine MD University of Virginia Health System, Charlottesville, VirginiaSearch for more papers by this authorLuiz R. Medina MD, Luiz R. Medina MD Hospital das Clinicas, Sao Paulo, BrazilSearch for more papers by this authorSultan Pradhan MD, Sultan Pradhan MD Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorVictor Schramm MD, Victor Schramm MD Center for Head and Neck Surgery, Denver, ColoradoSearch for more papers by this authorCarl Snyderman MD, Carl Snyderman MD University of Pittsburgh, Pittsburgh, PennsylvaniaSearch for more papers by this authorWilliam I. Wei MD, William I. Wei MD University of Hong Kong, Hong KongSearch for more papers by this authorJatin P. Shah MD, Corresponding Author Jatin P. Shah MD [email protected] Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this author Ian Ganly MD, PhD, Ian Ganly MD, PhD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorSnehal G. Patel MD, Snehal G. Patel MD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorBhuvanesh Singh MD, Bhuvanesh Singh MD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorDennis H. Kraus MD, Dennis H. Kraus MD Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorPatrick G. Bridger MD, Patrick G. Bridger MD Prince of Wales Hospital, Sydney, AustraliaSearch for more papers by this authorGiulo Cantu MD, Giulo Cantu MD Istituto Nazionale Tumori, Milan, ItalySearch for more papers by this authorAnthony Cheesman MD, Anthony Cheesman MD The Royal National Throat, Nose and Ear Hospital, London, United KingdomSearch for more papers by this authorGeraldo De Sa MD, Geraldo De Sa MD Istituto Nacional De Cancer, Rio de Janeiro, Brazil This author is deceased.Search for more papers by this authorPaul Donald MD, Paul Donald MD University of California-Davis Medical Center, Sacramento, CaliforniaSearch for more papers by this authorDan Fliss MD, Dan Fliss MD Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelSearch for more papers by this authorPatrick Gullane MD, Patrick Gullane MD Toronto General Hospital, Toronto, Ontario, CanadaSearch for more papers by this authorIvo Janecka MD, Ivo Janecka MD Massachusetts Eye and Ear Infirmary, Boston, MassachusettsSearch for more papers by this authorShin-etsu Kamata MD, Shin-etsu Kamata MD Cancer Institute Hospital, Tokyo, JapanSearch for more papers by this authorLuiz P. Kowalski MD, Luiz P. Kowalski MD Hospital do Cancer A.C. Camargo, Sao Paulo, BrazilSearch for more papers by this authorPaul Levine MD, Paul Levine MD University of Virginia Health System, Charlottesville, VirginiaSearch for more papers by this authorLuiz R. Medina MD, Luiz R. Medina MD Hospital das Clinicas, Sao Paulo, BrazilSearch for more papers by this authorSultan Pradhan MD, Sultan Pradhan MD Tata Memorial Hospital, Mumbai, IndiaSearch for more papers by this authorVictor Schramm MD, Victor Schramm MD Center for Head and Neck Surgery, Denver, ColoradoSearch for more papers by this authorCarl Snyderman MD, Carl Snyderman MD University of Pittsburgh, Pittsburgh, PennsylvaniaSearch for more papers by this authorWilliam I. Wei MD, William I. Wei MD University of Hong Kong, Hong KongSearch for more papers by this authorJatin P. Shah MD, Corresponding Author Jatin P. Shah MD [email protected] Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this author First published: 11 April 2005 https://doi.org/10.1002/hed.20166Citations: 216 † Presented at the North American Skull Base Society 15th Annual Meeting, New Orleans, February 13–17, 2004 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Background. Advances in imaging, surgical technique, and perioperative care have made craniofacial resection (CFR) an effective and safe option for treating malignant tumors involving the skull base. The procedure does, however, have complications. Because of the relative rarity of these tumors, most existing data on postoperative complications come from individual reports of relatively small series of patients. This international collaborative report examines a large cohort of patients accumulated from multiple institutions with the aim of identifying patient-related and tumor-related predictors of postoperative morbidity and mortality and set a benchmark for future studies. Methods. One thousand one hundred ninety-three patients from 17 institutions were analyzed for postoperative mortality and complications. Postoperative complications were classified into systemic, wound, central nervous system (CNS), and orbit. Statistical analyses were carried out in relation to patient characteristics, extent of disease, prior radiation treatment, and type of reconstruction to determine factors that predicted mortality or complications. Results. Postoperative mortality occurred in 56 patients (4.7%). The presence of medical comorbidity was the only independent predictor of mortality. Postoperative complications occurred in 433 patients (36.3%). Wound complications occurred in 237 (19.8%), CNS-related complications in 193 (16.2%), orbital complications in 20 (1.7%), and systemic complications in 57 (4.8%) patients. Medical comorbidity, prior radiation therapy, and the extent of intracranial tumour involvement were independent predictors of postoperative complications. Conclusions. CFR is a safe surgical treatment for malignant tumors of the skull base, with an overall mortality of 4.7% and complication rate of 36.3%. The impact of medical comorbidity and intracranial tumor extent should be carefully considered when planning therapy for patients whose tumors are amenable to CFR. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005 REFERENCES 1 Ketcham AS, Wilkins RH, van Buren JM, et al. A combined intracranial facial approach to the paranasal sinuses. Am J Surg 1963; 106: 698–703. 2 Ketcham AS, van Buren JM. Tumors of the paranasal sinuses: a therapeutic challenge. Am J Surg 1985; 150: 406–413. 3 Irish JC, Gullane PJ, Gentili F, et al. Tumors of the skull base: outcome and survival analysis of 77 cases. Head Neck 1994; 16: 3–10. 4 Janecka IP, Sen C, Sekhar LN, et al. Cranial base surgery: results in 183 patients. Otolaryngol Head Neck Surg 1994; 110: 539–546. 5 Kraus DH, Shah JP, Arbit E, Galicich JH, Strong EW. 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