J Neurol Surg B Skull Base 2022; 83(03): 265-269
DOI: 10.1055/s-0040-1722667
Original Article

Anterior Skull Base Sarcomas: Report of Characteristics and Outcomes at a Tertiary Care Cancer Center

Sallie Long*
1   Department of Otolaryngology—Head and Neck Surgery, New York-Presbyterian Hospital Columbia and Cornell, New York, New York, United States
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Panagiotis Asimakopoulos
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Marlena McGill
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Marc A. Cohen
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Snehal G. Patel
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Jatin P. Shah
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
,
Ian Ganly*
2   Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, United States
› Institutsangaben
Funding This project was partly supported by funding from NCI grant (grant no.: P30 CA008748).

Abstract

Objective This study was aimed to describe our institutional experience on characteristics and treatment outcomes of sinonasal sarcomas invading the anterior skull base.

Design Present study is a retrospective review.

Setting The study was conducted at an academic cancer care center.

Participants Thirty-one patients with skull base sarcomas treated with primary surgery from 1979 to 2015 were identified for this study from a preexisting database.

Main Outcome Measures Survival and recurrence outcomes using the Kaplan–Meier method were the focus areas of the study.

Results The median age was 44 years (range: 13–69 years). Twenty patients were male (64.5%). Twenty-nine patients underwent open craniofacial resection (93.5%) and two patients underwent endoscopic resection (6.5%). The majority of tumors were staged pT4 (77.4%). The most common pathologies were leiomyosarcoma (19.4%), osteosarcoma (16.1%), and chondrosarcoma (12.9%). Of those with known margin status, 10 patients had positive/close margins (32.2%) and 16 patients had negative margins (51.6%). Most tumors were high grade (74.2%). Twenty-three patients (74.2%) received adjuvant radiation and four patients (12.9%) received adjuvant chemotherapy. There were nine postoperative complications (29%) including one mortality and three cerebrospinal fluid leaks. There were 10 local, 2 regional, and 5 distant recurrences over a median follow-up of 74 months (range: 1–300 months). The 5-year disease-specific survival (DSS) was 69.8%. The 5-year locoregional recurrence-free probability (RFP) was 63.2% and the 10-year distant RFP was 71.7%. The 5-year DSS for high grade tumors was 64.2 and 85.7% for low grade tumors (p = 0.117).

Conclusion This study contributes an updated analysis of anterior skull base sarcomas. Five-year DSS is approximately 70%. Analysis of survival outcomes based on grade, tumor size, and other factors is limited by small sample size and the rarity of these tumors.

Note

The study was presented at the North American Skull Base Society Meeting, San Antonio, Texas, United States, February 7–9, 2020.


* These are first co-authors.




Publikationsverlauf

Eingereicht: 15. Mai 2020

Angenommen: 01. November 2020

Artikel online veröffentlicht:
21. Januar 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany