Management of squamous cell carcinoma of the temporal bone: long-term results and factors influencing outcomes

Piras, Gianluca; Grinblat, Golda; Albertini, Riccardo; Sykopetrites, Vittoria; Zhong, Shixun; Lauda, Lorenzo; Sanna, Mario

doi:10.1007/s00405-020-06378-w

Cited by 15 publications

(22 citation statements)

References 29 publications

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“…This occurred with a 40% rate in the 1980s, when imaging was provided only by CT, and thereafter dropped to 22% with combined CT‐MRI. Our results were consistent with other studies, considering en bloc, 10–19 piecemeal, 20–23 and en bloc LTBR‐piecemeal STTBR 24–31 resections.…”

Section: Discussionsupporting

confidence: 93%

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Treatment of advanced squamous cell carcinoma of the external auditory canal: Critical analysis of persistent failures in diagnosis and surgery with a competing‐risk model

et al. 2022

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Background: A series of temporal bone squamous cell carcinomas (TBSCCs) was analyzed with the aim of (i) better understanding the causes for the persistent high failure rate in advanced SCCs and (ii) discussing a possible way out from this stalemate in treatment.Methods: Forty-five TBSCCs consecutively treated surgically were reviewed. Results:The 5-year cumulative incidence for postoperative local recurrence was 41.8%. At multivariable analysis, pT3-4 stages were associated with eightfold relative incidence of developing local recurrence during follow-up (sHR = 9.06, 95% confidence interval [CI] = 1.18-69.46, p = 0.034) and cause-specific death (sHR = 7.95, 95%CI = 1.01-62.27, p = 0.048). Conclusions: The poor outcome in advanced TBSCC occurred because of local recurrence due to defective resection. The fundamental pitfall of surgery on advanced TBSCC appeared to be the insufficient knowledge of microscopic tumor growth in the different sites and subsites of the temporal bone. The serial histopathological study of the en bloc surgical specimen and autopsy temporal bones seems to represent a way to enhance our understanding of these tumors.

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Section: Discussionsupporting

confidence: 93%

“…Our results were consistent with other studies, considering en bloc, [10][11][12][13][14][15][16][17][18][19] piecemeal, [20][21][22][23] and en bloc LTBRpiecemeal STTBR [24][25][26][27][28][29][30][31] resections.…”

Section: Discussionsupporting

confidence: 93%

Treatment of advanced squamous cell carcinoma of the external auditory canal: Critical analysis of persistent failures in diagnosis and surgery with a competing‐risk model

et al. 2022

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“…For T1/T2 tumors, the 3-year rate of DSS was 100%, demonstrating a favorable outcome of en bloc resection using sleeve resection or LTBR. These results are consistent with those of previous studies demonstrating good prognosis of early stage EAC carcinoma (7,11,13,14). According to the NCCN guideline of head and neck cancers, positive margin cases for T1 patients should receive postoperative CCRT (15).…”

Section: Discussionsupporting

confidence: 91%

Treatment Outcome of External Auditory Canal Carcinoma: The Utility of Lateral Temporal Bone Resection

et al. 2021

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We examined the role of lateral temporal bone resection (LTBR) in the treatment of external ear canal (EAC) carcinoma between 2007 and 2018. The estimated 3-year disease-free survival (DFS) and disease-specific survival (DSS) according to the tumor stage and treatments were investigated in 36 patients with EAC squamous cell carcinoma. T stage classification according to the University of Pittsburgh staging system was as follows: 14 patients in T1, four patients in T2, nine patients in T3, and nine patients in T4. The 3-year DFS rate was 77.4% for T1 tumors, 100% for T2, 44.4% for T3 tumors, and 11.1% for T4 tumors (p < 001). The 3-year DSS rate was 100% for T1/T2 tumors, 87.5% for T3 tumors, and 11.1% for T4 tumors (p < 0.01). T1/T2 patients received mostly LTBR. Among nine T3 tumors, five patients (56%) received LTBR combined with preoperative chemotherapy and/or postoperative radiation (RT). Four of them had negative surgical margin and survived with no evidence of disease. The DFS of T3 patients who underwent concurrent chemoradiotherapy and LTBR was 0 and 80%, respectively (p = 0.048). For T1/T2 tumors, surgery achieved an excellent outcome. For T3 tumors, LTBR achieved negative surgical margin and showed good survival when combined with preoperative chemotherapy and/or postoperative RT. In contrast, the prognosis of T3 patients who could not undergo surgery was as poor as that of T4 patients. Therefore, in addition to subtotal temporal bone resection, LTBR-based treatment strategy may be a treatment option for limited cases of T3 patients.

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“…Several aspects of the behavior of TBSCC are far from having been fully elucidated 13 . Several staging systems have been proposed for the purpose of stratifying patients in terms of their prognosis 14–21 but none have been universally adopted 12 .…”

Section: Discussionmentioning

confidence: 99%

Primary temporal bone squamous cell carcinoma: Comparing the prognostic value of the American Joint Committee on Cancer TNM classification (8th edition) with the revised Pittsburgh staging system

et al. 2022

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Background Retrospectively considering a temporal bone squamous cell carcinomas (TBSCCs) series, our aim was to compare the predictive power of the American Joint Committee on Cancer (AJCC) staging system (8th edition) with the revised Pittsburgh staging system (rPSS) in terms of disease‐free survival (DFS), disease‐specific survival (DSS), and overall survival (OS). Methods Forty‐three TBSCCs consecutively treated surgically were reviewed. The prognostic performance of AJCC and rPSS was compared. Results The areas under the curves for the prediction of DFS, DSS, and OS did not differ significantly between both staging systems (p = 0.518, p = 0.940, and p = 0.910, respectively). Harrel's C‐indexes for respectively the AJCC and rPSS were 0.76 and 0.70 for DFS, 0.73 and 0.76 for DSS, 0.66 and 0.63 for OS. Conclusion Comparable prognostic accuracy was observed between AJCC and rPSS. Levels of prognostic performance were only acceptable for both systems, according to Hosmer–Lemeshow scale. Further efforts are needed to define new TBSCC staging modalities with higher prognostic reliability.

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Management of squamous cell carcinoma of the temporal bone: long-term results and factors influencing outcomes

Cited by 15 publications

References 29 publications

Treatment of advanced squamous cell carcinoma of the external auditory canal: Critical analysis of persistent failures in diagnosis and surgery with a competing‐risk model

Treatment of advanced squamous cell carcinoma of the external auditory canal: Critical analysis of persistent failures in diagnosis and surgery with a competing‐risk model

Treatment Outcome of External Auditory Canal Carcinoma: The Utility of Lateral Temporal Bone Resection

Primary temporal bone squamous cell carcinoma: Comparing the prognostic value of the American Joint Committee on Cancer TNM classification (8th edition) with the revised Pittsburgh staging system

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