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lüll A new classification for malignant tumors involving the anterior skull base Cantu G; Solero CL; Mariani L; Mattavelli F; Pizzi N; Licitra LArch Otolaryngol Head Neck Surg 1999[Nov]; 125 (11): 1252-7OBJECTIVES: To propose our clinical classification of malignant ethmoid tumors and to compare it with the last American Joint Committee on Cancer (AJCC)-Union Internationale Contre le Cancer (UICC) classification, published in 1997. DESIGN: Retrospective review. SETTING: Tertiary cancer facility. PATIENTS: We evaluated 123 consecutive patients undergoing craniofacial resection for malignant ethmoid tumors involving the anterior skull base. The mean follow-up was 60 months. Fifty-nine patients (48%) presented with recurrent disease after prior therapy. We classified them with a new classification system (Istituto Nazionale per lo Studio e la Cura dei Tumori) based on the most commonly accepted unfavorable prognostic factors (involvement of dura mater; intradural extension; involvement of the orbit and, in particular, of its apex; invasion of maxillary, frontal, and/or sphenoid sinuses; and invasion of the infratemporal fossa and skin. We also classified patients with the AJCC classification published in 1997. MAIN OUTCOME MEASURES: Disease-free status and overall survival rate. To study a possible association with tumor stage, the Cox regression model was adopted. RESULTS: According to our classification, patient distribution by tumor type was T2, n = 46; T3, n = 29; and T4, n = 48 (no T1 tumors were present in the series). For previously untreated patients, 5-year disease-free survival estimates were T2, 57%; T3, 50%; and T4, 13%. For relapses, corresponding figures were T2, 31%; T3, 23%; and T4, 1%. The prognostic difference among stages was statistically significant (P<.001). Similar results were obtained for overall survival. In contrast, patient distribution among different AJCC stages was less balanced, and we failed to detect a significant association with the clinical outcome using this classification. CONCLUSION: We propose the use of our staging system by all those specialists in the field willing to validate the classification and possibly apply it for clinical and investigational purposes.|Adult[MESH]|Aged[MESH]|Disease-Free Survival[MESH]|Dura Mater/pathology[MESH]|Ethmoid Bone/*pathology[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Frontal Sinus/pathology[MESH]|Humans[MESH]|Male[MESH]|Maxillary Sinus/pathology[MESH]|Middle Aged[MESH]|Neoplasm Invasiveness[MESH]|Neoplasm Recurrence, Local/classification/pathology[MESH]|Neoplasm Staging[MESH]|Orbit/pathology[MESH]|Prognosis[MESH]|Proportional Hazards Models[MESH]|Reproducibility of Results[MESH]|Retrospective Studies[MESH]|Skin/pathology[MESH]|Skull Base Neoplasms/*classification/pathology[MESH]|Skull Neoplasms/classification/pathology[MESH]|Sphenoid Sinus/pathology[MESH]|Survival Rate[MESH]|Temporal Bone/pathology[MESH] |