Skull Base 2011; 21(2): 087-092
DOI: 10.1055/s-0030-1266762
ORIGINAL ARTICLE

© Thieme Medical Publishers

Risk of Incisional Recurrence after Midface and Anterior Skull Base Surgery in Sinonasal Malignancies

Michael G. Moore1 , Derrick T. Lin2 , Daniel G. Deschler2 , Jing J. Wang3 , Annie W. Chan3
  • 1Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana
  • 2Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
  • 3Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
Further Information

Publication History

Publication Date:
30 September 2010 (online)

ABSTRACT

We sought to determine the risk of tumor incisional recurrence in patients receiving surgery and postoperative radiation therapy for locally advanced sinonasal malignancies. Medical records for 70 patients newly diagnosed with nonmetastatic American Joint Committee on Cancer stage II to stage IV sinonasal malignancies between 1991 and 2003 were retrospectively reviewed. Patient demographics and tumor variables were recorded. All patients underwent upfront surgical resection with postoperative three-dimensional conformal proton beam radiotherapy. Recurrence and survival-related outcomes were recorded. Two patients with squamous cell carcinoma had pathologically confirmed tumor recurrence at the incision site. The actuarial risk of incisional recurrence for the entire group at 1 year was 3%. One of the two patients had a maxillary sinus tumor and developed isolated skin recurrence along the transfacial incision. The other patient with an ethmoid sinus tumor developed isolated dural recurrence along the craniotomy incision. Both patients underwent multiple courses of salvage surgery and radiation therapy. One was successfully salvaged locally but developed distant metastases and the other died of local recurrence. Tumor seeding following transfacial and craniotomy surgery can occur, especially for squamous cell carcinoma. Sound oncological surgical technique, even when utilizing these difficult surgical approaches, is important to minimize incisional recurrence.

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Michael G MooreM.D. 

Assistant Professor, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine

550 North University Blvd. Room 3170, Indianapolis, IN 46202

Email: mooremg@iupui.edu