Which classification for ethmoid malignant tumors involving the anterior skull base?

Abstract

Both the 1997 and 2002 AJCC-UICC classifications seemed to have limited prognostic value. By contrast, the INT classification satisfied one of the main goals of tumor staging, demonstrating the progressive worsening of prognosis with different tumor classes.

Endoscopic endonasal craniotomy in the management of selected ethmoidal malignancies: The University of Pisa experience

“…A craniofacial resection combined with radiotherapy when necessary, has become the "gold standard" for tumours that have transgressed the anterior skull base. Several studies (Patel et al, 2003;Cantù et al, 2005) have shown a dramatic improvement of survival in patients who were considered incurable before the advent of this technique. Nevertheless, the morbidity and mortality of traditional craniofacial resection are quite high.…”

Endoscopic Surgery for Malignant Tumors of the Sinonasal Tract and Adjacent Skull Base: A 10-year Experience

“…We, indeed, believe that the major advantage of the endoscopic approach lies in the outstanding possibility of having a magnified visualization of the site of origin as well as of the areas involved by the tumor. [31][32][33] The largest series is a recent international collaborative study analyzing 1307 patients treated with ACFR at 17 institutions. In larger tumors the endoscopic surgeon must proceed in a step-by-step dissection (multilayer technique), usually starting with a debulking of the lesion and subsequently carrying out the dissection in a centripetal fashion starting far from areas involved by the tumor along the subperiosteal plane or by even including the underlying bone whenever at risk of involvement, with a constant progressive assessment of tumor boundaries.…”

Transfacial versus endoscopic approach in the treatment of woodworker's nasal adenocarcinomas

“…Its capacities for tissue invasion, osseous lysis, and proliferation seem rather reduced compared to other malignant neoplasms of the nose and sinuses . Metastases being rare, survival is dependent on local control . For the last 20 years, the gold standard treatment was based on the sequence: surgery then radiotherapy .…”