Skip to main content
Log in

Quality of life considerations for patients with anterior and central skull base malignancies

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Introduction

The extirpation of skull base malignancies may be associated with significant morbidity and can profoundly impact health related quality of life (HRQOL). In this review, we sought to provide an overview of HRQOL and the factors that influence it for patients with skull base malignancies.

Materials and Methods

Narrative review.

Results

HRQOL tends to improve in the months to years following treatment and is profoundly impacted by both tumor location and treatment approach. Wherever possible, HRQOL should always be elicited from the patient directly. Several HRQOL instruments have been used in this population including generic, site-specific and disease specific measures.

Conclusion

Given that HRQOL is a multidimensional concept with several important facets, validated disease-specific instruments are generally preferred.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ganly I, Patel SG, Singh B et al (2005) Complications of craniofacial resection for malignant tumors of the skull base: report of an International Collaborative Study. Head Neck 27(6):445–451

    PubMed  Google Scholar 

  2. Gil Z, Abergel A, Spektor S et al (2003) Quality of life following surgery for anterior skull base tumors. Arch Otolaryngol 129(12):1303–1309

    Google Scholar 

  3. Abu-Kishk I, Klin B, Gilady-Doron N, Jeroukhimov I, Eshel G (2013) Hospitalization due to horse-related injuries: has anything changed? A 25 year survey. Israel Med Assoc J 15(4):169–172

    Google Scholar 

  4. Gil Z, Fliss D (2010) Quality of life in patients with skull base tumors: current status and future challenges. Skull Base 20(01):011–018

    Google Scholar 

  5. Glicksman JT, Parasher AK, Brooks SG et al (2018) Sinonasal quality of life after endoscopic resection of malignant sinonasal and skull base tumors. Laryngoscope 128(4):789–793

    PubMed  Google Scholar 

  6. Derousseau T, Manjunath L, Harrow B, Zhang S, Batra PS. Long‐term changes in quality of life after endoscopic resection of sinonasal and skull‐base tumors. Paper presented at: International forum of allergy & rhinology2015.

  7. Shah JP (2010) Quality of life after skull base surgery: the patient's predicament. Skull Base 20(01):003–004

    Google Scholar 

  8. Kirkman MA, Borg A, Al-Mousa A, Haliasos N, Choi D (2014) Quality-of-life after anterior skull base surgery: a systematic review. J Neurol Surg B 75(02):073–089

    Google Scholar 

  9. Schaberg MR (2018) Quality of life outcomes after endoscopic approaches to intracranial tumors. Curr Opin Otolaryngol Head Neck Surg 26(1):58–64

    PubMed  Google Scholar 

  10. Group W (1995) The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 41(10):1403–1409

    Google Scholar 

  11. Guyatt GH, Feeny DH, Patrick DL (1993) Measuring health-related quality of life. Ann Intern Med 118(8):622–629

    CAS  PubMed  Google Scholar 

  12. Velikova G, Booth L, Smith AB et al (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 22(4):714–724

    PubMed  Google Scholar 

  13. Myers EN, Hammerlid E, Persson L-O, Sullivan M, Westin T (1999) Quality-of-life effects of psychosocial intervention in patients with head and neck cancer. Otolaryngology 120(4):507–516

    Google Scholar 

  14. Ringash J, Bezjak A (2001) A structured review of quality of life instruments for head and neck cancer patients. Head Neck 23(3):201–213

    CAS  PubMed  Google Scholar 

  15. Gil Z, Abergel A, Spektor S, Khafif A, Fliss DM (2004) Patient, caregiver, and surgeon perceptions of quality of life following anterior skull base surgery. Arch Otolaryngol 130(11):1276–1281

    Google Scholar 

  16. Karnofsky DA (1949) The clinical evaluation of chemotherapeutic agents in cancer. Eval Chemother Agents 9:191–205

    Google Scholar 

  17. Holmes B, Sekhar L, Sofaer S, Holmes K, Wright D (1995) Outcomes analysis in cranial base surgery—preliminary results. Acta Neurochir 134(3–4):136–138

    CAS  PubMed  Google Scholar 

  18. Walch C, Stammberger H, Anderhuber W, Unger F, Köle W, Feichtinger K (2000) The minimally invasive approach to olfactory neuroblastoma: combined endoscopic and stereotactic treatment. Laryngoscope 110(4):635–640

    CAS  PubMed  Google Scholar 

  19. Raso JL, Gusmão S (2006) Transbasal approach to skull base tumors: evaluation and proposal of classification. Surg Neurol 65:S33–S37

    Google Scholar 

  20. Tzortzidis F, Elahi F, Wright D, Natarajan SK, Sekhar LN (2006) Patient outcome at long-term follow-up after aggressive microsurgical resection of cranial base chordomas. Neurosurgery 59(2):230–237

    PubMed  Google Scholar 

  21. Di Maio S, Rostomily R, Sekhar LN (2011) Current surgical outcomes for cranial base chordomas: cohort study of 95 patients. Neurosurgery 70(6):1355–1360

    Google Scholar 

  22. Samii A, Gerganov V, Herold C, Gharabaghi A, Hayashi N, Samii M (2009) Surgical treatment of skull base chondrosarcomas. Neurosurg Rev 32(1):67

    PubMed  Google Scholar 

  23. Lang D, Honeybul S, Neil-Dwyer G, Evans B, Weller R, Gill J (1999) The extended transbasal approach: clinical applications and complications. Acta Neurochir 141(6):579–585

    CAS  PubMed  Google Scholar 

  24. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I: Conceptual framework and item selection. Med Care 30:473–483

    PubMed  Google Scholar 

  25. Ransom ER, Doghramji L, Palmer JN, Chiu AG (2012) Global and disease-specific health-related quality of life after complete endoscopic resection of anterior skull base neoplasms. Am J Rhinol Allerg 26(1):76–79

    Google Scholar 

  26. Ware JE Jr, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    PubMed  Google Scholar 

  27. Torrance GW, Feeny DH, Furlong WJ, Barr RD, Zhang Y, Wang Q (1996) Multiattribute utility function for a comprehensive health status classification system: Health Utilities Index Mark 2. Med Care 34(7):702–722

    CAS  PubMed  Google Scholar 

  28. Hassan SJ, Weymuller EA (1993) Assessment of quality of life in head and neck cancer patients. Head Neck 15(6):485–496

    CAS  PubMed  Google Scholar 

  29. Rogers SN, Gwanne S, Lowe D, Humphris G, Yueh B, Weymuller EA Jr (2002) The addition of mood and anxiety domains to the University of Washington quality of life scale. Head Neck 24(6):521–529

    PubMed  Google Scholar 

  30. Martinez-Devesa P, Barnes M, Alcock C, Kerr R, Milford C (2006) Evaluation of quality of life and psychiatric morbidity in patients with malignant tumours of the skull base. J Laryngol Otol 120(12):1049–1054

    CAS  PubMed  Google Scholar 

  31. Palme CE, Irish JC, Gullane PJ, Katz MR, Devins GM, Bachar G (2009) Quality of life analysis in patients with anterior skull base neoplasms. Head Neck 31(10):1326–1334

    PubMed  Google Scholar 

  32. List MA, D'Antonio LL, Cella DF et al (1996) The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy‐head and neck scale: a study of utility and validity. Cancer 77(11):2294–2301

    CAS  PubMed  Google Scholar 

  33. Hopkins C, Gillett S, Slack R, Lund V, Browne J (2009) Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 34(5):447–454

    CAS  PubMed  Google Scholar 

  34. Gil Z, Abergel A, Spektor S, Shabtai E, Khafif A, Fliss DM (2004) Development of a cancer-specific anterior skull base quality-of-life questionnaire. J Neurosurg 100(5):813–819

    PubMed  Google Scholar 

  35. Little AS, Jahnke H, Nakaji P, Milligan J, Chapple K, White WL (2012) The anterior skull base nasal inventory (ASK nasal inventory): a clinical tool for evaluating rhinological outcomes after endonasal surgery for pituitary and cranial base lesions. Pituitary 15(4):513–517

    PubMed  Google Scholar 

  36. Little AS, Kelly D, Milligan J et al (2013) Prospective validation of a patient-reported nasal quality-of-life tool for endonasal skull base surgery: the Anterior Skull Base Nasal Inventory-12. J Neurosurg 119(4):1068–1074

    PubMed  Google Scholar 

  37. ten Dam E, Feijen RA, van den Berge MJ et al (2017) Development of the endoscopic endonasal sinus and skull base surgery questionnaire. Paper presented at: International forum of allergy & rhinology

  38. de Almeida JR, Vescan AD, Gullane PJ et al (2012) Development of a disease-specific quality-of-life questionnaire for anterior and central skull base pathology—the skull base inventory. Laryngoscope 122(9):1933–1942

    PubMed  Google Scholar 

  39. Abergel A, Cavel O, Margalit N, Fliss DM, Gil Z (2012) Comparison of quality of life after transnasal endoscopic vs open skull base tumor resection. Arch Otolaryngol 138(2):142–147

    Google Scholar 

  40. Fliss DM, Abergel A, Cavel O, Margalit N, Gil Z (2007) Combined subcranial approaches for excision of complex anterior skull base tumors. Arch Otolaryngol 133(9):888–896

    Google Scholar 

  41. ten Dam E, Korsten-Meijer AG, Hoving EW et al (2019) Evaluation of the psychometric properties of the endoscopic endonasal sinus and skull base surgery questionnaire (EES-Q) in a prospective cohort study. Clin Otolaryngol 44:565–571

    PubMed  Google Scholar 

  42. Larjani S, Monteiro E, Witterick I et al (2016) Preliminary cross-sectional reliability and validity of the Skull Base Inventory (SBI) quality of life questionnaire. J Otolaryngol 45(1):45

    Google Scholar 

  43. de Almeida JR, Vescan AD, Witterick IJ et al (2015) Changes experienced in quality of life for skull base surgical patients: a qualitative case study. J Neurol Surg B 76(02):129–144

    Google Scholar 

  44. de Almeida JR, Witterick IJ, Vescan AD (2011) Functional outcomes for endoscopic and open skull base surgery: an evidence-based review. Otolaryngol Clin North Am 44(5):1185–1200

    PubMed  Google Scholar 

  45. de Almeida JR, Snyderman CH, Gardner PA, Carrau RL, Vescan AD (2011) Nasal morbidity following endoscopic skull base surgery: a prospective cohort study. Head Neck 33(4):547–551

    PubMed  Google Scholar 

  46. Woertgen C, Rothoerl RD, Hosemann W, Strutz J (2007) Quality of life following surgery for malignancies of the anterior skull base. Skull Base 17(02):119–123

    PubMed  PubMed Central  Google Scholar 

  47. de Almeida JR, Witterick IJ, Gullane PJ et al (2013) Physical morbidity by surgical approach and tumor location in skull base surgery. Head Neck 35(4):493–499

    PubMed  Google Scholar 

  48. Hadad G, Bassagasteguy L, Carrau RL et al (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116(10):1882–1886

    PubMed  Google Scholar 

  49. Meccariello G, Deganello A, Choussy O et al (2016) Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: a pooled-analysis of 1826 patients. Head Neck 38(S1):E2267–E2274

    PubMed  Google Scholar 

  50. Rawal RB, Farzal Z, Federspiel JJ, Sreenath SB, Thorp BD, Zanation AM (2016) Endoscopic resection of sinonasal malignancy: a systematic review and meta-analysis. Otolaryngology 155(3):376–386

    Google Scholar 

  51. Farquhar D, Kim L, Worrall D et al (2016) Propensity score analysis of endoscopic and open approaches to malignant paranasal and anterior skull base tumor outcomes. Laryngoscope 126(8):1724–1729

    PubMed  Google Scholar 

  52. Husain Q, Joshi RR, Cracchiolo JR et al (2019) Surgical management patterns of sinonasal malignancy: a population-based study. J Neurol Surg B 80(04):371–379

    Google Scholar 

  53. Carrabba G, Dehdashti AR, Gentili F (2008) Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach. Neurosurg Focus 25(6):E7

    PubMed  Google Scholar 

  54. Fatemi N, Dusick JR, Gorgulho AA et al (2008) Endonasal microscopic removal of clival chordomas. Surg Neurol 69(4):331–338

    PubMed  Google Scholar 

  55. Pant H, Bhatki AM, Snyderman CH et al (2010) Quality of life following endonasal skull base surgery. Skull Base 20(01):035–040

    Google Scholar 

  56. McCoul E, Anand K, Schwartz T (2012) Improvements in site-specific quality of life 6 months after endoscopic anterior skull base surgery: a prospective study—clinical article. J Neurosurg 117:498–506

    PubMed  Google Scholar 

  57. Castelnuovo P, Pagella F, Delù G, Benazzo M, Cerniglia M (2003) Endoscopic resection of nasal haemangiopericytoma. Eur Arch Otorhinolaryngol 260(5):244–247

    PubMed  Google Scholar 

  58. Abergel A, Fliss DM, Margalit N, Gil Z (2010) A prospective evaluation of short-term health-related quality of life in patients undergoing anterior skull base surgery. Skull Base 20(01):027–033

    Google Scholar 

  59. Fukuda K, Saeki N, Mine S et al (2000) Evaluation of outcome and QOL in patients with craniofacial resection for malignant tumors involving the anterior skull base. Neurol Res 22(6):545–550

    CAS  PubMed  Google Scholar 

  60. Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Levin VA, Cella DF (1995) The functional assessment of cancer therapy (FACT) scale: development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumors. Cancer 75(5):1151–1161

    CAS  PubMed  Google Scholar 

  61. Meyers CA, Hess KR (2003) Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neuro Oncol 5(2):89–95

    PubMed  PubMed Central  Google Scholar 

  62. Meyers CA, Geara F, Wong P-F, Morrison WH (2000) Neurocognitive effects of therapeutic irradiation for base of skull tumors. Int J Rad Oncol Biol Phys 46(1):51–55

    CAS  Google Scholar 

  63. Deschler DG, Walsh KA, Friedman S, Hayden RE (1999) Quality of life assessment in patients undergoing head and neck surgery as evaluated by lay caregivers. Laryngoscope 109(1):42–46

    CAS  PubMed  Google Scholar 

Download references

Funding

No funding sources to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John R. de Almeida.

Ethics declarations

Conflict of interest

All authors declare that they have no competing interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Noel, C.W., de Almeida, J.R. Quality of life considerations for patients with anterior and central skull base malignancies. J Neurooncol 150, 501–508 (2020). https://doi.org/10.1007/s11060-019-03367-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-019-03367-w

Keywords

Navigation