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Quality of Life Following Surgery for Anterior Skull Base Tumors
Ziv Gil, MD, PhD;
Avraham Abergel, MD;
Sergei Spektor, MD;
Jacob T. Cohen, MD;
Avi Khafif, MD;
Esther Shabtai, MSc;
Dan M. Fliss, MD
Arch Otolaryngol Head Neck Surg. 2003;129:1303-1309.
Objectives To evaluate patients' quality of life (QOL) after surgical extirpation of anterior skull base tumors, to elucidate different QOL domains, and to define possible predictors of functional outcome postoperatively.
Design Retrospective survey.
Setting University-affiliated medical center.
Participants Sixty-nine patients (76 consecutive cases) who underwent subcranial surgery between 1994 and 2002 for extirpation of anterior skull base tumors.
Main Outcome Measure A multidimensional, disease-specific questionnaire with 39 items was used. Six relevant domains of QOL were assessed: role of performance, physical functioning, vitality, pain, specific symptoms, and impact on emotions.
Results The response rate for completing the questionnaire was 98% (40/41) after excluding patients who died (n = 13), were lost to follow-up (n = 10), and were operated on within 3 months of commencement of the study (n = 5). Thirty patients (74%) reported a significant improvement or no change in overall QOL within 6 months after surgery. The worst impact of surgery on the patients' QOL was on their financial status and emotional state. The most influential factor on QOL was malignancy leading to a significant decrease in the overall score. Radiotherapy, old age, comorbidity, and wide resection also significantly worsened QOL scores of specific domains.
Conclusion After subcranial extirpation of anterior skull base tumors, the overall outcome of the patients is good. Old age, malignancy, comorbidity, wide resection, and radiotherapy are negative prognostic factors for these patients' QOL.
From the Department of OtolaryngologyHead and Neck Surgery and the Skull Base Surgery Unit (Drs Gil, Cohen, Khafif, and Fliss), the Department of Neurosurgery (Dr Spektor), and The Statistical Service, (Ms Shabtai), Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine (Dr Abergel), Tel-Aviv University, Tel-Aviv, Israel. The authors have no relevant financial interest in this article.
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