Abstract
Objective This study was aimed to describe our institutional experience on characteristics
and treatment outcomes of sinonasal sarcomas invading the anterior skull base.
Design Present study is a retrospective review.
Setting The study was conducted at an academic cancer care center.
Participants Thirty-one patients with skull base sarcomas treated with primary surgery from 1979
to 2015 were identified for this study from a preexisting database.
Main Outcome Measures Survival and recurrence outcomes using the Kaplan–Meier method were the focus areas
of the study.
Results The median age was 44 years (range: 13–69 years). Twenty patients were male (64.5%).
Twenty-nine patients underwent open craniofacial resection (93.5%) and two patients
underwent endoscopic resection (6.5%). The majority of tumors were staged pT4 (77.4%).
The most common pathologies were leiomyosarcoma (19.4%), osteosarcoma (16.1%), and
chondrosarcoma (12.9%). Of those with known margin status, 10 patients had positive/close
margins (32.2%) and 16 patients had negative margins (51.6%). Most tumors were high
grade (74.2%). Twenty-three patients (74.2%) received adjuvant radiation and four
patients (12.9%) received adjuvant chemotherapy. There were nine postoperative complications
(29%) including one mortality and three cerebrospinal fluid leaks. There were 10 local,
2 regional, and 5 distant recurrences over a median follow-up of 74 months (range:
1–300 months). The 5-year disease-specific survival (DSS) was 69.8%. The 5-year locoregional
recurrence-free probability (RFP) was 63.2% and the 10-year distant RFP was 71.7%.
The 5-year DSS for high grade tumors was 64.2 and 85.7% for low grade tumors (p = 0.117).
Conclusion This study contributes an updated analysis of anterior skull base sarcomas. Five-year
DSS is approximately 70%. Analysis of survival outcomes based on grade, tumor size,
and other factors is limited by small sample size and the rarity of these tumors.
Keywords
head and neck sarcoma - skull base sarcoma - paranasal sarcoma - sarcoma outcomes
