侧颅底相关头颈部恶性肿瘤分析

目的 侧颅底相关头颈部恶性肿瘤治疗难度大、预后较差,本研究旨在探讨其治疗方法及预后相关因素.方法 回顾性分析55例侧颅底相关头颈部恶性肿瘤患者的资料.均采用手术为主的治疗,其中颈下颔入路23例,颞下窝入路24例,颅面联合入路6例,上颔骨外翻入路1例,Weber-Ferguson+Lynch延长切口1例.结果 全组局部复发率41.8％,远处转移率14.5％,3年总体生存率为50.9％.单因素分析,初治患者3年生存率60.6％,复治患者3年生存率36.4％.Cox模型分析,初治复治与病理类型差异具有统计学意义.结论 初治复治及病理类型是侧颅底相关恶性肿瘤的独立预后因素.应重视侧颅底相关恶性肿瘤的外科治疗,合理的手术方法以及必要的辅助治疗有望改善侧颅底相关恶性肿瘤的预后.

Retrospective analysis of lateral skull base-related head and neck malignancies

OBJECTIVE The lateral skull base-related head and neck malignancy（LSBHNM）is difficult to management and its prognosis is poor. This study was to investigate the treatment and prognostic factors of LSBHNM. METHODS Clinical and follow-up data of 55 patients with LSBHNM were reviewed. All patients underwent operation and the surgical approaches included transcervical-mandibular approach（23 cases）, transinfratemporal approach（24 cases）, skull-face combined approaches（6 cases）, maxillary swing approach（1 case）and Weber-Ferguson and Lynch approach（1 case）.RESULTS The local recurrence rate was 41.8% and distant metastasis rate was 14.5%. The 3-year overall survival rate was 50.9%. In univariate survival analysis, the 3-years overall survival rate of initial treated patients was 60.6%, and re-treated patients was 36.4%（P〈0.05）. Multivariate analysis showed that the P-value of initial treatment or retreatment and pathological type were less than 0.05. CONCLUSION The initial treatment or retreatment and pathological type are the independent prognostic factors of LSBHNM. Great attention should be paid to surgical treatment of LSBHNM. Reasonable surgery and adjuvant therapy could be expected to improve the prognosis of LSBHNM.