Craniofacial resection for T4 squamous cell carcinoma of maxillary sinus

Abstract

[OBJECTIVE] There are limited data regarding outcome analysis in patients who have undergone craniofacial resection of T4 squamours cell carcinoma of maxillary sinus. The purpose of this study was to evaluate the survival rate of patients with maxillary cancers invading the infratemporal fossa who underwent anterolateral skull base resection. [METHODS] At Nagoya University Hospital, 126 patients underwent craniofacial resection during 21-year period. Among them, 34 patients underwent anterolateral cranial base resections for T4 maxillary squamous cell carcinoma ; 21 cases were stage T4a and 13 tumors were in stage T4b according the UICC (7th edition) classification, and 4 cases were with Cavernous sinus resection. The median follow-up time was 38.7 months (range 12 to 158). [RESULTS] The 5-year survival rate was 60.3% (T4a : 75.1%, T4b : 51.3%), and the relapse-free survival rates was 43.7% (T4a : 46.8%, T4b : 39.9%) at 5 years, respectively. Univariate analysis showed that surgical margin and recurrent disease had a significant effect on the five-year overall survival and disease-free survival. [Conclusion] Anterolateral skull base resection is an effective treatment for T4 maxillary cancer. Patients with positive surgical margins show a poorer prognosis. The mortality and the morbidity is acceptable without cavernous sinus resection.