Squamous cell carcinoma of the temporal bone: outcomes of radical surgery and postoperative radiotherapy

Abstract

Objectives/hypothesis: To analyze the treatment outcomes for squamous cell carcinoma (SCC) of the temporal bone and to identify factors that may influence prognosis.

Study design: Retrospective case series.

Methods: Case notes review of patients with histologically proven SCC of the temporal bone who had treatment with a curative intent at a tertiary referral center in the Northwest of England, United Kingdom.

Results: A total of 35 patients were treated in this unit over a 12-year period. The most common presentation was otorrhoea, which was present in all patients, followed by otalgia (66%), bleeding (54%), and facial palsy (46%). The overall survival for this series was 48.6%. There were four patients with stage I tumor, and one case each of stage II and stage III disease. The disease-free survival for patients with stage I to stage III disease in this series was 100%. The remaining 29 patients (84%) had stage IV disease, with an overall survival in this group of 41.4%. The average survival period of the 18 patients who succumbed to local disease was 9.2 months (range 3-22). Poorly differentiated SCC was associated with significantly poorer survival (P < 0.05) when compared to well and moderately differentiated SCC. Parotid involvement of SCC, node-positive neck, and the presence of preoperative facial palsy was not associated with poorer survival outcomes.

Conclusions: SCC of the temporal bone is a highly malignant disease that is associated with high morbidity and mortality despite aggressive multimodal treatment.

Level of evidence: 4.

Keywords: Pittsburgh staging system; Squamous cell carcinoma; external auditory canal; radiotherapy; resection; temporal bone.