|
Evolving
Role of Skullbase Surgery for Patients with Low and High Grade
Malignancies
Franco DeMonte
Department
of Neurosurgery and Head and Neck Surgery, The University of Texas
M.D. Anderson Cancer Center 1515 Holcombe Blvd Houston TX 77030 USA;
Tel.: +1-713-792-2400; Fax: +1-713-794-4950; E-mail:fdemonte@mdanderson.org
Malignancy
involving the skull base remains a formidable management
challenge.
Advances and refinements in diagnostic imaging, instrumentation,
microvascular reconstruction, and an improved overall appreciation of
the anatomy of the skullbase have extended the boundaries of tumor
resectability and in some cases, obviated the need for adjuvant
therapies.
Successful management of high-grade malignancy however, requires a
carefully constructed multi-modal treatment plan to maximize patient
outcome.
Over
the course of an 11-year period, 259 patients with skullbase
malignancies were treated by the author in the setting of a tertiary
care comprehensive cancer center.
All patients were evaluated by a multidisciplinary team experienced in
the assessment and treatment of skullbase malignancy.
Management paradigms were constructed and treatment based, on
categorization into low or high-grade malignancy, was recommended and
undertaken.
This
manuscript discusses this patient population and the outcome of the
management paradigms that were constructed.
Differences in outcome based on the characterization of malignancies
as either low or high grade is discussed.
Complications of treatment and patient reported quality of life
outcomes are reviewed.
Keywords: malignancy,
quality of life, skullbase
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://ipsapp007.kluweronline.com/IPS/content/ext/x/J/5042/I/124/A/15/abstract.htm
|
