Update on Surgical Outcomes of Lateral Temporal Bone Resection for Ear and Temporal Bone Malignancies

Sinha, Sumi; Dedmon, Matthew M.; Naunheim, Matthew R.; Fuller, Jennifer; Gray, Stacey T.; Lin, Derrick T.

doi:10.1055/s-0036-1579882

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…These figures are comparable to previously published outcomes. 1,4,24 Although the present study did not find a statistically significant reduction in OS and DSS in patients with N+ disease, despite a reduction in mean survival, there are data to suggest poorer prognosis in patients with lymph node involvement. 1,25 The failure of the present study to demonstrate this difference most likely arises from the limited sample size.…”

Section: Discussioncontrasting

confidence: 89%

Pattern of nodal metastasis of cutaneous squamous cell carcinoma involving the temporal bone

Hintze

O'Riordan

Jones

et al. 2022

Laryngoscope Investig Oto

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Objective: The objective of this study was to explore the pattern of lymph-node spread of SCCs involving the temporal bone. Methods:We retrospectively reviewed all cutaneous SCCs involving the temporal bone over a 20-year time-period. Forty-one patients were eligible.Results: Mean age was 72.8 years. The diagnosis was cutaneous SCC in all cases.All patients underwent a temporal bone resection, 70.7% had a neck-dissection and 78.0% a parotidectomy.Level 2 was the most common area of neck metastasis, and occurred in 12.2%. The parotid had disease in 34.1%. 51.2% of patients underwent free-flap reconstruction.Mean overall survival of the cohort was 4.2 years.Conclusions: Overall, the rate of cervical nodal metastasis was 22.0% and 13.5% in the occult setting. The parotid was involved in 34.1% and 10.0% in the occult setting.Results from the present study support consideration for performing a parotidectomy at the time of temporal bone resection, while a neck dissection can be performed for adequate staging of the nodal basin.

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Section: Discussioncontrasting

confidence: 89%

Pattern of nodal metastasis of cutaneous squamous cell carcinoma involving the temporal bone

Hintze

O'Riordan

Jones

et al. 2022

Laryngoscope Investig Oto

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“…When surgeons chose the radical surgery such as subtotal resection of the temporal bone, expert techniques were needed because of its rarity and the complex anatomy of the temporal bone involving critical organs, such as the internal carotid artery, cranial nerves, dura mater, and brain. Moreover, negative margin of the surgical specimens was harder to get than that in other head and neck cancers such as oral, pharyngeal, and laryngeal cancers 4,8,15–17 . However, effective CRT has not been obvious thus far because of the rarity of this disease.…”

Section: Discussionmentioning

confidence: 99%

Multi‐institutional Survey of Squamous Cell Carcinoma of the External Auditory Canal in Japan

et al. 2020

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Objectives This study aimed to evaluate the efficacy of chemoradiotherapy (CRT) for patients with advanced cancer of the external auditory canal (EAC) by analyzing the outcome of the patients. Methods This is a multi‐institutional retrospective survey, and we reviewed the medical records of the subjects. A total of 181 patients with tumor (T)3 or T4 tumor in 17 institutions were enrolled. Further analysis was performed for 74 patients who underwent CRT under curative intent. Results Overall 5‐year survival rates of the patients who underwent CRT (n = 74) were 54.6%. Those of the patients who underwent CRT with modified TPF (docetaxel, cisplatin [CDDP], and 5‐fluorouracil) regimen (n = 50) and CRT with CDDP regimens (n = 24) were 64.4% and 36.7%, respectively. Significant differences were observed between these two groups. Conclusion Given the tendency that head and neck surgeons prefer CRT for advanced larger cancer of the EAC, CRT for advanced EAC cancer using the modified TPF regimen showed good clinical outcomes. Level of Evidence 4 Laryngoscope, 131:E870–E874, 2021

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“…Lateral temporal bone resection (LTBR) with or without concurrent parotidectomy and selective neck dissection (SND) is designed to remove the primary tumor en bloc as well as to microscopically stage the disease and determine the need for postoperative chemo-and/or radiation therapy. [4][5][6] While the histologic diagnosis of EAC SCC is straightforward, precise identification of genomic features that may contribute to the particularly aggressive nature of these tumors is unclear. Molecular markers may improve prognostic significance and when combined with surgical staging (Pittsburgh classification), may provide insight into optimal management of these rare and aggressive tumors.…”

Section: Introductionmentioning

confidence: 99%

Targeted molecular characterization of external auditory canal squamous cell carcinomas

Basura

Smith

Ellsperman

et al. 2021

Laryngoscope Investig Oto

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Hypothesis: Squamous cell carcinomas (SCC) of the external auditory canal (EAC) may harbor unique genomic alterations that may explain aggressive behavior and differentiate these tumors from cutaneous SCCs of other subsites.Background: EAC SCCs arise in a non-ultraviolet-exposed region of the head and neck, are often locally aggressive and may metastasize to lymph nodes or distant sites. The genomic alterations underlying cutaneous SCC of other sites are welldocumented; however, mutational profiles of EAC SCC are less well characterized and may contribute to the unique anatomic site, high rates of recurrence and tumor spread. We performed targeted sequencing of a cohort of primary EAC SCCs to identify recurring and potentially targetable genomic alterations.Methods: Genomic DNA was extracted from formalin-fixed paraffin-embedded specimens of 7 EAC SCCs and subjected to targeted DNA sequencing using a 227-gene panel. Somatic alterations and gene copy number alterations were annotated using our validated, in-house bioinformatics pipelines.Results: In our EAC SCCs, we found recurrent alterations in TP53 and genes of receptor tyrosine kinase (eg, EGFR, FGFR) and PI3K pathways (eg, PIK3CA), similar to cutaneous SCCs of other head and neck sites. We also observed a high frequency of telomerase reverse transcriptase amplification and DNA methyltransferase 1 alterations, both of which are rarely observed in cutaneous SCCs of other sites. Conclusion:These data represent the first step toward precise molecular characterization of EAC SCCs that may lead to an enhanced understanding of tumor biology and modernized precision medicine approaches for unique tumors.

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Update on Surgical Outcomes of Lateral Temporal Bone Resection for Ear and Temporal Bone Malignancies

Cited by 4 publications

References 10 publications

Pattern of nodal metastasis of cutaneous squamous cell carcinoma involving the temporal bone

Pattern of nodal metastasis of cutaneous squamous cell carcinoma involving the temporal bone

Multi‐institutional Survey of Squamous Cell Carcinoma of the External Auditory Canal in Japan

Targeted molecular characterization of external auditory canal squamous cell carcinomas

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