Efficacy of surgical treatments for squamous cell carcinoma of the temporal bone: A literature review

Abstract

A review of all publications dealing with surgical treatment for squamous cell carcinomas of the temporal bone was performed. No randomized or nonrandomized control studies were identified. All studies were case series without control subjects. Twenty-six of 96 publications, which contained information on 144 patients, were analyzed. Several inferences are suggested by the available evidence; however, these areas should be investigated by properly designed randomized clinical trials: (1) patients with carcinoma that is confined to the external auditory canal have similar survival, regardless of whether mastoidectomy, lateral temporal bone resection (TBR), or subtotal TBR is performed: the addition of radiation therapy to lateral TBR does not appear to improve survival; (2) when disease extends into the middle ear, survival of patients treated with subtotal TBR appeared to be improved over those treated with lateral TBR or mastoidectomy: it remains uncertain if the addition of radiation therapy to mastoidectomy improves survival; (3) the value of surgical resection when carcinoma extends to involve the petrous apex remains unclear; (4) resection of involved dura mater does not appear to improve survival; however, incomplete data regarding margins of resection were reported; and (5) determination of the value of resection of involved brain parenchyma or internal carotid artery will require further study.

Predictors of Survival and Recurrence after Temporal Bone Resection for Cancer

“…The extant literature consists of numerous case series that have reported a wide range of survival data, reflecting differences in the underlying characteristics of cohorts drawn from various institutions. 1,6,[8][9][10][12][13][14][15]18,19,22,24,[30][31][32][33][34][35][36][37][38][39][40][41] Historical survival data can be most readily generalized to clinical practice if factors predictive of outcome can be identified. Several larger series have reported preliminary descriptions of factors influencing survival, based on univariate comparisons.…”

“…These numbers are reflections of the underlying characteristics of the patient cohort at each institution. [8][9][10][11][12][13][14][15][17][18][19]22,23,[30][31][32]34,35,[37][38][39][40][41][42] Attempting to improve understanding of prognostic factors, 5 groups have recently analyzed outcomes using univariate analyses. In 1997, Testa et al 20 Based on these outcomes data, we currently consider the minimum operation for the vast majority of malignant disease involving the external auditory canal/temporal bone to be a lateral temporal bone resection.…”

Operative Management of Skull Base Malignant Tumors Arising From the Nasal Cavity and Paranasal Sinus: Recent Strategies Used in 25 Cases

“…1) However, whether aggressive resection helps to prolong survival significantly remains unclear. 13) In our previous series of 15 patients who underwent anterolateral cavernous sinus excision, the 5-year disease-free survival rate was 0%. 5) Therefore, we considered that malignant tumors requiring anterolateral cavernous sinus excision contraindicate surgery, and stereotactic radiotherapy and chemotherapy should take precedence in such patients.…”

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“…A retrospective review including 144 patients did not find evidence of improved survival with the addition of RT to TBR (with 48 vs. 44.4% 5-year survival for TBR + RT vs. TBR alone, respectively) [34]. Wang [25] reported that Adjuvant postoperative RT was not significantly correlated with the overall survival rates but it is unnecessary for early stage EAC SCC, particularly in patients with guaranteed intraoperative tumor-free margins.…”