EXTENDED ANTERIOR CRANIOFACIAL RESECTION FOR INTRACRANIAL EXTENSION OF MALIGNANT-TUMORS

OBJECTIVE: To review our experience with anterior craniofacial resecti on for malignant neoplasms with intracranial extension, Survival was a nalyzed in terms of presence of intracranial extension, extent of intr adural disease, tumor histology, and histological status of margins. P ATIENTS: in a retrospective review made at a tertiary cancer facility, 26 of the 115 consecutive patients undergoing craniofacial resection for malignant lesions of the anterior skull base had intracranial exte nsion, defined as dural and/or brain extension. Survival was evaluated with the Kaplan-Meier product limit method, and comparisons between i ndividual subgroups were performed using the fog-rank test. RESULTS: P atients with intradural extension have a statistically worse disease-s pecific survival than patients without intracranial extension (P = 0.0 5), Surgical margins and tumor histology impact on survival. The incid ence of local complications was 42% and of systemic complications, 8%. CONCLUSION: Anterior craniofacial resection is indicated for patients with resectable disease, The complication rate is comparable with tha t of patients without intracranial extension. Gross total resection wi th histologically negative margins portends a better prognosis. Esthes ioneuroblastoma has a better prognosis than other tumor types. (C) 199 7 by Excerpta Medica, Inc.