Multicenter experiences in temporal bone cancer surgery based on 89 cases

Abstract

Objective: To present outcomes of extensive surgery: lateral, subtotal, total petrosectomies in patients with temporal bone invasion resulting from specific primary cancers.

Study design: Retrospective case review.

Setting: Four tertiary referral centers.

Material: 89 patients with cancer of the temporal bone treated between January 2006 and December 2010.

Intervention: Multidisciplinary team approach including surgical resection, reconstruction, and postoperative radiotherapy.

Main outcome measure: Disease-specific survival, overall survival.

Results: In 27.0% of the patients, relapse was reported, with an average of 6.3 months after surgery; 31 patients (34.8%) died during the follow-up. The average mortality was 22.1 months. Fifty-four patients (58.7%) stayed alive during the time of observation. The average survival time was 42.0 months. The median time of survival with relapse was 12 months (range: 1-51 months). The three-year disease-free rate was 38.0% and the overall survival rate was 58.7%.

Conclusions: Petrosectomy is an effective treatment for malignant temporal bone invasion. The probability of a good outcome was statistically decreased with a high T grade, positive margins, and salvage surgery. Younger age is connected with better prognosis. One of the major tasks remains to improve detection and to shorten the time to diagnosis, keeping in mind that symptoms are insidious and in younger people, the time before diagnosis was longer.

Fig 1. Difference in age between alive and death patients.

Fig 2. Survival analysis for the group of 89 patients with temporal bone invasion, considered due to localization of the primary.

Fig 3. Extent of the surgery and survival.