Prognostic factors in pterygopalatine and infratemporal fossa malignant tumours: A single institution experience.

PURPOSE: To elucidate the clinical characteristics of malignancies involving the pterygopalatine and infratemporal fossa and identify the outcome-related predictors.

METHODS: A retrospective review of the patients diagnosed with malignancies involving these spaces between 2006 and 2013 was conducted. We investigated the 5-year recurrence free survival, metastasis free survival and overall survival, and univariate and multivariate analysis were used to identify the outcome-related factors.

RESULTS: A total of 80 patients (46 male and 34 female) aged from 1 to 82 years were retrospectively analysed. The most frequent location for involved malignancies included the pterygopalatine fossa (n = 35, 43.8%), followed by the infratemporal fossa (n = 25, 31.2%) and the pterygopalatine and infratemporal fossa together (n = 20, 25%). In multivariate analysis, gender (HR: 2.59, 95% CI: 1.034-6.488, p = 0.042), margin status (HR: 6.158, 95% CI: 2.115-17.932, p = 0.001) and adjuvant radiotherapy (HR: 3.116, 95% CI: 1.057-9.191, p = 0.039) were predictors for the 5-year recurrence-free survival rate, and brain invasion (HR: 6.218, 95% CI: 1.375-28.115, p = 0.018) and surgical margin (HR: 21.961, 95% CI: 2.383-202.418, p = 0.006) were predictors for the 5-year overall survival rate.

CONCLUSION: These results indicate that malignancies involving the pterygopalatine and infratemporal fossa have a poor prognosis. Brain invasion is a dangerous sign for decreased survival. An ideal surgical margin is associated with a lower recurrence and higher survival rate. Adjuvant radiotherapy should be performed to achieve better local control.