Predictors of surgical complications in surger y of disseminated skull base tumors

Abstract

Post-surgical complications are rather important, and, perhaps, more significant factors determining the efficiency of the provided treatment together with the natural oncological disease course, accompanying pathology, and peculiarities of the adjuvant therapy. The decrease in the frequency and severity of these complications, revealing of modifiable and non-modifiable risk factors, their prevention and reduction are definitely of scientific and practical interest. The aim of the work is the search for predictors of post-surgical complications in the patients with disseminated malignant skull base tumors. The retro-prospective single-center cohort study based on the analysis of the results of surgical treatment of 161 patients with such neoplasms was carried out. The study covered the patients at the age of 19–84 years, with the average age of 55 years (statistical deviation: +\- 1.2). There were 78 women and 83 men. Accordingly, the sex distribution was 1:1.064. The pre-surgical radical radiotherapy was made for 43 patients (26.71 %); 21 patients (13.04 %) underwent one or several cycles of multiagent chemotherapy. Morphologically, there were 16 different types of tumors, among which the epithelial tumors 40.37 % (n=65) prevailed: epidermoid cancer — 16.15 % (n=26), sinonasal cancer — 8.07 % (n=13), and acinic cell carcinoma 5.59 % (n=9). Sarcomas were diagnosed in 12 patients (7.45 %). The study results demonstrate the lack of particular statistically substantiated symptoms or clinical factors — predictors, individually and independently affecting the unfavorable results of the surgical treatment of the patients with disseminated malignant skull base tumors. On the contrary, the syndromological combination of local, general and organizational problems definitely influences the surgery result significantly, while not all mathematically predicted combinations can be formalized into some clinical equivalent.