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DOI: 10.1055/s-0032-1313929
Multidisciplinary Approach to Anterior Skull Base Sarcomas
Objective: The aim of this study was to report our experience with malignant soft tissue tumors of the anterior skull base. A multidisciplinary approach was done.
Design: Retrospective study.
Materials and Methods: We report our experience about a heterogeneous group of eight cases managed from 2004 to 2010 by a multidisciplinary board.
Results: Two patients with low-grade tumors underwent endonasal endoscopic surgery alone; one patient with low-grade large tumor underwent craniofacial resection plus radiotherapy; two patients with high-grade tumors were treated with a multimodal nonsurgical approach (neoadjuvant chemotherapy, radiotherapy, and adjuvant chemotherapy); one patient with intermediate-grade sarcoma was treated with neoadjuvant chemotherapy followed by endoscopic endonasal surgery; two patients with high-grade sarcomas underwent neoadjuvant chemotherapy, high-dose chemotherapy, and surgery or radiotherapy plus surgery. The medium follow-up was 48 months without complications. All of them are alive, one with disease.
Conclusions: The management of soft tissue sarcomas is a great challenge. Tumor grade, size, and surgical margins significantly affect local recurrence rates and distant failure, and they reduce disease-specific survival. A “tailored therapy” must be planned in each case. Only a multidisciplinary approach allows effective local control of disease, improving survival rate.