Skull base XXXX : Long term surgical outcome and prognostic factors.

@entity1 @entity1653 @entity5 @entity1758
PURPOSE: The aim of this study was to examine the clinical outcomes of treating @entity1653 at the skull base region following surgical resection and adjuvant radiotherapy, and to analyze the association between clinical characteristics and progression free survival. MATERIALS AND METHODS: Twenty-eight @entity1 with skull base atypical @entity1653 underwent microsurgical resection between June 2001 and November 2009. The clinical characteristics of the @entity1 and @entity1653 , the extent of surgical resection, and complications after treatment were retrospectively analyzed. RESULTS: Thirteen @entity1 (46.4%) had disease recurrence or progression during follow up time. The median time to disease progression was 64 months. The extent of the surgical resection significantly impacted prognosis. Gross total resection (GTR) of the @entity5 improved progression free survival (PFS) compared to subtotal resection (STR, p=0.011). An older @entity1 age at diagnosis also resulted in a worse outcome (p=0.024). An @entity1758 index <8% also contributed to improved PFS (p=0.031). None of the @entity1 that underwent GTR and received adjuvant radiotherapy had @entity5 recur during follow up. STR with adjuvant radiotherapy tended to result in better local @entity5 control than STR alone (p=0.074). Three of 28 @entity1 (10.7%) developed complications after microsurgery. The GTR group had a higher rate of complications than those with STR. There were no late adverse effects after adjuvant radiotherapy during follow up. CONCLUSION: For @entity1 with skull base atypical @entity1653 , GTR is desirable for longer PFS, unless radical excision is expected to lead to severe complications. Adjuvant radiation therapy is advisable to reduce @entity5 recurrence regardless of the extent of surgical resection. Age of disease onset and the @entity1758 index of the @entity5 were both independent prognostic factors of clinical outcome.
