鼻窦恶性肿瘤多模式治疗(包括内窥镜手术)的发病率:一项针对 940 名患者的国际合作研究(MUSES)的结果。

IF 2.3 3区 医学 Q1 OTORHINOLARYNGOLOGY
Giacomo Bertazzoni, Alessandro Vinciguerra, Domitille Camous, Marco Ferrari, Davide Mattavelli, Mario Turri-Zanoni, Alberto Schreiber, Stefano Taboni, Vittorio Rampinelli, Alberto Daniele Arosio, Benjamin Verillaud, Cesare Piazza, Paolo Battaglia, Maurizio Bignami, Alberto Deganello, Paolo Castelnuovo, Piero Nicolai, Philippe Herman
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引用次数: 0

摘要

导言:在鼻窦恶性肿瘤的治疗中,手术方法(内窥镜和开放性切除术)和非手术疗法引起的发病率和死亡率越来越重要。这项多中心研究旨在评估鼻窦恶性肿瘤内窥镜手术和非手术疗法(新辅助疗法和/或辅助疗法)的相关并发症:方法:纳入所有在三家具有统一管理政策的转诊中心接受内窥镜或内窥镜辅助手术治疗的鼻腔鼻窦恶性肿瘤患者。根据组织学和病理报告进行新辅助和/或辅助(化疗)放疗。研究人员检索了人口统计学、治疗特点以及与手术和非手术方法相关的并发症。通过单变量和多变量统计对数据进行分析,以评估并发症的独立预测因素:共纳入 940 名患者,其中男性 643 人(占 68%),女性 297 人(占 32%)。187名患者(19.9%)共出现了225种并发症:最常见的并发症有脑脊液(CSF)漏(3.5%)、粘液囊(2.3%)、手术部位出血(2.0%)、口外衄(2.0%)和放射性坏死(2.0%)。治疗相关死亡率为 0.4%。在多变量分析中,与并发症独立相关的变量主要是硬脑膜切除术(OR 1.92)、颅内镜或多孔道切除术(OR 2.93)、少于三层的多层硬脑膜修复技术(OR 2.17)以及不同于髂胫束的移植物(OR 3.29):我们的研究表明,鼻窦恶性肿瘤的现代内窥镜治疗和放射治疗与有限的发病率和治疗相关死亡率相关。脑脊液漏和放射性坏死虽然罕见,但仍是最常见的并发症,今后的研究工作应进一步解决这一问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Morbidity of multimodal treatments including endoscopic surgery for sinonasal malignancies: Results of an international collaborative study on 940 patients (MUSES).

Introduction: In the management of sinonasal malignancies treatment-induced morbidity and mortality is gaining relevance both for surgical approaches (endoscopic and open resection) and non-surgical therapies. The aim of this multicenter study is to assess complications associated with endoscopic surgery and non-surgical treatments (neoadjuvant and/or adjuvant) for malignant sinonasal tumors.

Methods: All patients with nasoethmoidal malignancies treated with curative intent with endoscopic or endoscopic-assisted surgery at three referral centers with uniform management policies were included. Neo- and/or adjuvant (chemo)radiotherapy was administered according to histology and pathological report. Demographics, treatment characteristics, and complications related both to the surgical and non-surgical approaches were retrieved. The data were analyzed with univariate and multivariate statistics to assess independent predictors of complications.

Results: Nine hundred and forty patients were included, 643 males (68%) and 297 females (32%). A total of 225 complications were identified in 187 patients (19.9%): cerebrospinal fluid (CSF) leak (3.5%), mucocele (2.3%), surgical site bleeding (2.0%), epiphora (2.0%), and radionecrosis (2.0%) were the most common. Treatment-related mortality was 0.4%. Variables independently associated with complications at multivariate analysis were principally dural resection (OR 1.92), cranioendoscopic or multiportal resection (OR 2.93), dural repair with multilayer technique with less than three layers (OR 2.17), and graft different from iliotibial tract (OR 3.29).

Conclusion: Our study shows that modern endoscopic treatments and radiotherapy for sinonasal malignancies are associated with limited morbidity and treatment-related mortality. CSF leak and radionecrosis, although rare, remain the most frequent complications and should be further addressed by future research efforts.

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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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