Soroush Farsi, John Q. Odom, J. Reed Gardner, Michael Held, Deanne King, Jumin Sunde, Emre Vural, Mauricio A. Moreno
{"title":"Oncological outcomes of partial thickness calvarial resection for locally advanced scalp malignancies","authors":"Soroush Farsi, John Q. Odom, J. Reed Gardner, Michael Held, Deanne King, Jumin Sunde, Emre Vural, Mauricio A. Moreno","doi":"10.1016/j.amjoto.2024.104456","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Traditionally, locally advanced scalp malignancies have been managed through composite, full-thickness calvarial resection. The aim of this study is to explore the oncologic outcomes of partial calvarial resection for locally invasive scalp malignancies without medullary space invasion, employing a burr-down approach.</p></div><div><h3>Study design</h3><p>Retrospective case series.</p></div><div><h3>Setting</h3><p>Tertiary referral center.</p></div><div><h3>Methods</h3><p>This study analyzed records of 26 adult patients diagnosed with scalp cancer that spread to the calvarial region. Data collected included demographics, medical history, adjuvant therapy details, imaging, surgical outcomes, and postoperative oncological results.</p></div><div><h3>Results</h3><p>26 patients with cancerous scalp lesions necessitating calvarial resection for deep margin control were identified in 22 men and 4 women. Mean age at diagnosis was 72.7 years. The most common histopathological diagnosis was Squamous cell carcinoma (<em>n</em> = 16). Partial removal of the calvarial lesions was achieved in all patients without any intraoperative complications. Twelve patients received adjuvant therapy consisting of the following modalities: radiation (6), chemotherapy (1), immunotherapy (1), a combination of immunotherapy and radiation (2), and a combination of chemotherapy and radiotherapy (2). There was a total of 7 recurrences: local (<em>n</em> = 3,11.5 %), regional (n = 3,11.5 %), distal (<em>n</em> = 1,3.8 %). Long term local control was achieved in (<em>n</em> = 23,88.4 %) of patients. The mean time of follow-up was 19.1 months, and the mean time to recurrence was 15.1 months.</p></div><div><h3>Conclusion</h3><p>Partial calvarial resection represents a viable, safe, and effective surgical technique for cancerous tissue removal, reducing risks associated with full thickness calvarial resection, and enhancing soft tissue healing when compared to the established gold standard.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104456"},"PeriodicalIF":1.8000,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0196070924002424","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Traditionally, locally advanced scalp malignancies have been managed through composite, full-thickness calvarial resection. The aim of this study is to explore the oncologic outcomes of partial calvarial resection for locally invasive scalp malignancies without medullary space invasion, employing a burr-down approach.
Study design
Retrospective case series.
Setting
Tertiary referral center.
Methods
This study analyzed records of 26 adult patients diagnosed with scalp cancer that spread to the calvarial region. Data collected included demographics, medical history, adjuvant therapy details, imaging, surgical outcomes, and postoperative oncological results.
Results
26 patients with cancerous scalp lesions necessitating calvarial resection for deep margin control were identified in 22 men and 4 women. Mean age at diagnosis was 72.7 years. The most common histopathological diagnosis was Squamous cell carcinoma (n = 16). Partial removal of the calvarial lesions was achieved in all patients without any intraoperative complications. Twelve patients received adjuvant therapy consisting of the following modalities: radiation (6), chemotherapy (1), immunotherapy (1), a combination of immunotherapy and radiation (2), and a combination of chemotherapy and radiotherapy (2). There was a total of 7 recurrences: local (n = 3,11.5 %), regional (n = 3,11.5 %), distal (n = 1,3.8 %). Long term local control was achieved in (n = 23,88.4 %) of patients. The mean time of follow-up was 19.1 months, and the mean time to recurrence was 15.1 months.
Conclusion
Partial calvarial resection represents a viable, safe, and effective surgical technique for cancerous tissue removal, reducing risks associated with full thickness calvarial resection, and enhancing soft tissue healing when compared to the established gold standard.
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