Predictors of Survival and Recurrence after Temporal Bone Resection for Cancer

Abstract

Background. The purpose of this study was to identify factors predictive of outcome in patients undergoing temporal bone resection (TBR) for head and neck cancer.Methods. This was a retrospective study of 72 patients undergoing TBR. Factors associated with survival and recurrence were identified on multivariable regression. Results. Most tumors were epithelial (81%), commonly (69%) involving critical structures. Cervical metastases were uncommon (6%). Squamous cell carcinoma (SCC) of the external auditory canal carried a high rate of parotid invasion (25%) and parotid nodal metastases (43%).The 5-year rate of overall survival (OS) was 62%; disease-specific survival (DSS), 70%; recurrence-free survival (RFS), 46%. Factors independently associated with outcome on multivariable analysis were margin status and extratemporal spread of disease to the parotid, mandible, or regional nodes. Recurrence was common (72%) in cT3-4 tumors. Conclusions. Margin status and extratemporal disease spread are the strongest independent predictors of survival and recurrence. In SCC of the external auditory canal, high rates of parotid involvement support adjunctive parotidectomy. Risk of recurrence in T3-T4 tumors may support a role for adjuvant therapy.

Unresectable Recurrent Squamous Cell Carcinoma of the Temporal Bone Treated by Induction Chemotherapy Followed by Concurrent Chemo-Reirradiation

“…Only one patient experienced long-term survival. Morris et al (11) reported that patients who had unresectable TBSCC had a mean survival of 7.6 months. Haginomori et al (12) reported a patient who had recurrent tumor invasion to the occipital condyle.…”

Temporal bone carcinoma: Classical prognostic variables revisited and modern clinico-pathological evidence

“…11,13,16,17 The pathological grading of the tumor was reported as a factor related to worse prognosis only in a limited number of series. 10,18 In part, facial nerve involvement continues to be controversial with a significant negative prognostic role found by most 11,12,15,16,[19][20][21][22] but not all groups. 23 Dura mater infiltration evidence (both radiological and/or pathological) was reported in most of the series 10,11,21,22 as the strongest negative prognostic factor affecting survival.…”

23 Extracranial Tumors Involving the Skull Base

“…• Squamous cell carcinoma (SCC) is the most common malignancy in adults, followed by basal cell carcinoma, adenoid cystic carcinoma, and adenocarcinoma. 63 • In pediatric patients, the most common diagnosis is rhabdomyosarcoma. 64 • Given the rarity of temporal bone neoplasms reported in the literature, various histological subtypes are often grouped together when discussing management and treatment.…”