Squamous cell carcinoma of the temporal bone: the impact of local control on survival

Abstract

Background

Squamous cell carcinoma (SCC) of the temporal bone (TB) is a rare pathology originating from the external auditory canal (EAC). Surgery remains the gold standard to achieve local control.

Aims/Objectives:

The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) after surgery of the SCC of EAC.

Material and methods

A retrospective chart review in a tertiary referral center included 26 patients: 23 were operated with lateral temporal bone resection (LTBR, n = 10) and extended temporal bone resection (ETBR, n = 13). The outcomes were OS and DFS.

Results

Adjuvant radiotherapy was performed in 91.3% (n = 21/23). Mean age was 60.8 and sex ratio was 1. Median follow-up was 43 months; The 5-years OS was 90% (± 9.5%) and 47.7% (± 12.9%) for stage I/II and III/IV respectively (p = .033). DFS was 67.6% (IC 95%, 51.4%–88.9%) without statistical difference between early advanced stage. Incomplete margins (p = .004) and Stage IV(p < .001) were associated with poorer DFS. Free margins significantly correlated with better OS (HR = 9.8, p = .04).

Conclusion

En bloc surgical resection with free margins, coupled with postoperative radiotherapy, provides optimal local control. For stage IV tumors, where complete margins are achievable, ETBR is recommended to enhance local control.

Chinese Abstract

背景

颞骨 (TB) 鳞状细胞癌 (SCC) 是一种罕见的源自外耳道 (EAC)的病理现象。 手术仍然是实现局部控制的金标准。

目的

本研究的目的是评估外耳道鳞状细胞癌手术后的总生存期(OS)和无病生存期 (DFS)。

材料和方法

在三级转诊中心对 26 名患者进行了回顾性图表审查: 23 例接受外侧颞骨切除术(LTBR, n = 10)和延长颞骨切除(ETBR, n = 13)。 结果是 OS 和 DFS。

结果

辅助放疗的实施率为 91.3% (n = 21/23)。 平均年龄 60.8 岁, 性别比为 1。中位随访时间为 43 个月； I/II 期和III/IV 期的5 年 OS 分别为 90% (± 9.5%) 和 47.7% (± 12.9%)(p=.033)。 DFS 为 67.6%(IC 95%, 51.4%–88.9%), 与早晚期相比无统计学意义上的区别。 不完整切缘 (p=.004) 和 IV 期 (p<.001) 与较差的 DFS 相关。干净切缘与更好的 OS 显著相关(HR = 9.8, p=.04)。

结论

整块手术切除并取得干净切缘, 结合术后放疗, 导致最佳的局部控制。 对于可以实现完整切缘的 IV 期肿瘤, 建议延长颞骨切除以加强局部控制。

Keywords:

• Temporal bone
• squamous cell carcinomas
• petrectomy
• survival
• local control

Disclosure statement

No potential conflict of interest was reported by the author(s).