Outcome of craniofacial surgery in children and adolescents with malignant tumors involving the skull base: an international collaborative study.
Head Neck. 2009 Mar;31(3):308-17
Authors: Gil Z, Patel SG, Cantu G, Fliss DM, Kowalski LP, Singh B, Snyderman C, Kraus DH, Shah JP, , Bridger PG, Cheesman AD, Donald P, Gullane P, Janecka I, Kamata SE, Levine PA, Medina LR, Pradhan S, Schramm V, Wei WI
BACKGROUND: The aim of the study was to characterize the distribution of anterior skull base (ASB) cancers in the pediatric population and to identify predictors of outcome. METHODS: This was an international study of 1307 patients undergoing craniofacial surgery for malignant tumors; 6.4% (n = 84) among these were <or=21 years old. RESULTS: The most common histologic type was sarcoma (40%), followed by squamous cell carcinoma (14%). Higher incidence of tumors was found in older children (7.5-21 years) compared to younger children. The 5-year disease-specific and overall survival rates were 61% and 55%, respectively (median follow-up of 30 months). The best prognosis was associated with low-grade sarcomas and the worst with salivary and squamous cell carcinomas. High-grade sarcoma represented an intermediate risk group. On multivariate analysis, prior radiotherapy and histology were independent predictors of survival. CONCLUSION: Surgery for malignant tumors involving the ASB is feasible and safe in children. Histology is significant determinant of poor outcome in this population.
PMID: 19073003 [PubMed - indexed for MEDLINE]