Quality of Life following Surgery for Malignancies of the Anterior Skull Base

ABSTRACT

Radical surgery combined with postoperative radiation is recommended to achieve the best outcomes in patients suffering from malignant anterior skull base tumors. However, information on the impact of such treatment on the quality of life of these patients is sparse. This retrospective study evaluated quality of life in patients with anterior skull base malignancies after transdural resection and radiotherapy. At follow-up, 36% of the patients were alive (mean survival time, 39 months). Only 45% of the patients were able to work in their previous occupation a mean of 15 months after surgery. At follow-up, 58% of the patients had a recurrent tumor. The mean quality of life index was 42 points (range, 0 to 100). The lowest values were on the job item, and the highest mean value was on the family item. All patients, dependents, or both would agree to surgery in the future. Based on these findings, quality of life after transdural surgery for the treatment of anterior skull base malignancies seems to be low.

KEYWORDS

Quality of life - malignancies - anterior skull base - tumor

REFERENCES

• 1 Sekhar L N, Moller A R. Operative management of tumors involving the cavernous sinus.  J Neurosurg. 1986;  64 879-889
• 2 Boyle J O, Shah K C, Shah J P. Craniofacial resection for malignant neoplasms of the skull base: an overview.  J Surg Oncol. 1998;  69 275-284
• 3 Pitman K T, Prokopakis E P, Aydogan B et al.. The role of skull base surgery for the treatment of adenoid cystic carcinoma of the sinonasal tract.  Head Neck. 1999;  21 402-407
• 4 Joos U, Mann W, Gilsbach J. Microsurgical treatment of midfacial tumors involving the skull base.  J Craniomaxillofac Surg. 1998;  26 226-234
• 5 Hendryk S, Czecior E, Misiolek M, Namyslowski G, Mrowka R. Surgical strategies in the removal of malignant tumors and benign lesions of the anterior skull base.  Neurosurg Rev. 2004;  27 205-213
• 6 Lang D A, Honeybul S, Neil-Dwyer G, Evans R T, Weller R O, Gill J. The extended transbasal approach: clinical applications and complications.  Acta Neurochir (Wien). 1999;  141 579-585
• 7 Fukuda K, Saeki N, Mine S et al.. Evaluation of outcome and QOL in patients with craniofacial resection for malignant tumors involving the anterior skull base.  Neurol Res. 2000;  22 545-550
• 8 Neil-Dwyer G, Lang D A, Davis A. Outcome from complex neurosurgery: an evidence based approach.  Acta Neurochir (Wien). 2000;  142 367-371
• 9 Blau T. Quality of life, social indicators, and criteria of change.  Prof Psychol. 1977;  11 464-473
• 10 Richtsmeier W J, Briggs R J, Koch W M et al.. Complications and early outcome of anterior craniofacial resection.  Arch Otolaryngol Head Neck Surg. 1992;  118 913-917
• 11 Kraus D H, Sterman B M, Levine H L, Wood B G, Tucker H M, Lavertu P. Factors influencing survival in ethmoid sinus cancer.  Arch Otolaryngol Head Neck Surg. 1992;  118 367-372
• 12 Clayman G L, DeMonte F, Jaffe D et al.. Outcome and complications of extended cranial-base resection requiring microvascular free-tissue transfer.  Arch Otolaryngol Head Neck Surg. 1995;  121 1253-1257
• 13 Naficy S, Disher M J, Esclamado R M. Adenoid cystic carcinoma of the paranasal sinuses.  Am J Rhinol. 1999;  4 311-314
• 14 Woertgen C, Rothoerl R D, Brawanski A. Early S-100 serum values correlate to quality of life after severe head injury.  Brain Inj. 2002;  16 807-816
• 15 Woertgen C, Erban P, Rothoerl R D, Bein T, Horn M, Brawanski A. Quality of life after decompressive craniectomy in patients suffering from supratentorial brain ischemia.  Acta Neurochir (Wien). 2004;  146 691-695