Artikel
Chondrosarcoma of the base of the skull
Chondrosarkome der Schädelbasis
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Veröffentlicht: | 8. Mai 2006 |
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Objective: We present a consecutive series of 25 patients with skull base chondrosarcoma.
Methods: Retrospective analysis of 18 male and 7 female patients (mean age 36.0±11.4 years) who underwent a total of 39 operations between 1984 and 2002 in Nordstadtkrankenhaus Hannover.
Results: Most of the patients presented preoperatively with unilateral abducens nerve palsy (52%). A large variety of approaches were used to remove the tumour. The three most often used approaches were: the retrosigmoid approach (30.4%), the pterional approach (23.1%) and the transethmoidal approach (15.4%). Only one patient suffered from a WHO grade III chondrosarcoma, while the rest had low grade chondrosarcomas. The histology had no effect on the outcome. We performed a neuroradiological analysis of 12 patients that revealed a mean volume of 16.9 ml, with most tumours growing unilaterally and involving the clivus in all cases and the petrous bone in 83%. Tumour removal was radical in 49% of all and in 52% of primary operations. In 20 patients a follow-up with a mean interval of 82 months after primary surgery could be obtained. Eight of these patients received various types of radiation therapy. Two patients died and 18 patients are still alive with a mean Karnofsky index of 90%. There is no longer overall survival rate for radically operated patients compared to the ones with non radical tumour removal. Though the clinical outcome was better following subtotal tumour removal, this was however not significant. The overall 5 and 10 year survival rates are 95%.
Conclusions: Skull base chondrosarcomas are slow growing tumors with a 95% ten year survival rate. Therefore, aggressiveness of tumour resection should not compromise quality of life since radical tumour removal does not significantly increase survival rates in these patients.