Efficacy of transnasal endoscopic resection for malignant anterior skull-base tumors

John W. Wood, Jean Anderson Eloy, Richard J. Vivero, Zoukaa Sargi, Francisco J. Civantos, Donald T. Weed, Jaques J. Morcos, Johnathan Castaño, Kaming Lo Mph, Roy R. Casiano

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Background: Craniofacial resection (CFR) has been the standard of care for malignant tumors of the anterior skull base (ASB). However, during the past 2 decades, transnasal endoscopic resection (TER) has gained significant popularity. The purpose of this study is to compare CFR and TER with respect to perioperative and oncologic outcomes. Methods: Retrospective analysis at a tertiary care medical center of 82 consecutive patients undergoing resection of tumors of the ASB between 1997 and 2011. Results: Thirty-four patients underwent TER, while 48 patients underwent CFR. There was no statistical difference in major complications between the two groups (p = 0.29). However, TER patients had shorter operating room times (284 minutes for TER, 620 minutes for CFR; p < 0.001), lower intraoperative blood loss (675 mL for TER, 1000 mL for CFR; p = 0.005), shorter intensive care unit (ICU) stays (0 days for TER, 3 days for CFR; p < 0.001), and shorter hospital stays (4.5 days for TER; 7 days for CFR; p < 0.001). There were no differences for the rates of en bloc resection, negative margins, or disease-specific mortality. Subanalysis yielded a median follow-up of 5 years postoperatively. There were no differences in disease-specific mortality or recurrences in this group. Conclusion: Patients undergoing TER for tumors of the ASB are more likely to leave the ICU and the hospital earlier than their CFR counterparts. Furthermore, for carefully selected patients undergoing TER, excellent oncologic outcomes with survival and recurrence rates similar to patients undergoing CFR may be achieved. Comparison of oncologic outcomes, however, may be limited by discrepancy in histologic grade and clinical stage between the two groups. Nonetheless, TER seems to be an excellent alternative to CFR in appropriately selected patients.

Original languageEnglish (US)
Pages (from-to)487-495
Number of pages9
JournalInternational Forum of Allergy and Rhinology
Volume2
Issue number6
DOIs
StatePublished - Nov 1 2012

Keywords

  • Anterior skull base
  • Craniofacial
  • Craniofacial resection
  • Endoscopic anterior skull base resection
  • Skull-base tumors
  • Transnasal endoscopic resection

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

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