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. 2021 Aug;41(4):308-316.
doi: 10.14639/0392-100X-N1074.

Surgical treatment for squamous cell carcinoma of the temporal bone: predictors of survival

Conrad F Smit  1 , Niels de Boer  1 , Birgit I Lissenberg-Witte  2 , Paul Merkus  1 , Erik F Hensen  1   3 , C René Leemans  1
Affiliations

Surgical treatment for squamous cell carcinoma of the temporal bone: predictors of survival

Conrad F Smit et al. Acta Otorhinolaryngol Ital. 2021 Aug.

Abstract
in English, Italian

Objective: Evaluation of the management and survival in patients treated for temporal bone squamous cell carcinoma (TBSCC) in a tertiary referral centre.

Methods: Forty-nine patients underwent primary treatment for TBSCC. Thirty-six patients underwent a lateral temporal bone resection (LTBR) or subtotal temporal bone resection (STBR). Overall survival (OS) and disease-specific survival (DSS) analysis were assessed.

Results: Five-year OS of the 49 patients was 39%. Five-year OS of the 36 patients who underwent LTBR or STBR was 46%. Tumour-free margins were achieved in all patients with T1 and T2 disease, in 59% patients with T3 tumours and 0% patients with T4 disease. Five-year DSS was 85% for all T1/T2 tumours, 53% for T3 tumours and 0% for T4 tumours. Clear resection margins was the only significant predictor of DSS in our cohort.

Conclusions: The mainstay of treatment for TBSCC is temporal bone resection with tumour free resection margins, with or without adjuvant radiotherapy. Survival is negatively influenced by non-radical resection. T1 and T2 tumours can be managed safely with LTBR. More advanced disease requires a more extensive resection, with a higher likelihood of non-radical resections and decreased survival rates.

Il trattamento chirurgico del carcinoma a cellule squamose dell’osso temporale: fattori predittivi di sopravvivenza.

Obiettivo: Valutazione della gestione e sopravvivenza in pazienti trattati per carcinoma a cellule squamose dell’osso temporale (TBSCC) in un centro di riferimento terziario.

Metodi: Quarantanove pazienti sono stati sottoposti a trattamento primario per TBSCC. Trentasei pazienti sono stati sottoposti a resezione ossea temporale laterale (LTBR) o resezione ossea temporale subtotale (STBR). Sono state eseguite analisi della sopravvivenza globale (OS) e della sopravvivenza specifica per la malattia (DSS).

Risultati: l’OS a cinque anni di tutti i 49 pazienti è stata del 39%. L’OS a cinque anni di tutti i 36 pazienti sottoposti a LTBR o STBR è stata del 46%. Margini liberi da tumore sono stati raggiunti in tutti i pazienti con malattia T1 e T2, nel 59% dei pazienti con tumori T3 e nello 0% pazienti con malattia T4. Il DSS a cinque anni era dell’85% per tutti i tumori T1 / T2, del 53% per i tumori T3 e dello 0% per i tumori T4. I margini di resezione chiari erano l’unico predittore significativo di sopravvivenza specifica per malattia nella nostra coorte.

Conclusioni: Il cardine del trattamento per TBSCC è la resezione dell’osso temporale con margini di resezione senza tumore, con o senza radioterapia adiuvante. La sopravvivenza è influenzata negativamente dalla resezione irradicale. I tumori T1 e T2 possono essere gestiti in sicurezza con LTBR. Una malattia più avanzata richiede una resezione più estesa, con una maggiore probabilità di resezioni irradicali e tassi di sopravvivenza ridotti.

Keywords: lateral temporal bone resection; squamous cell carcinoma; subtotal temporal bone resection; survival analysis; temporal bone carcinoma.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Overall survival of all 49 patients treated with curative intent, grouped by their treatment.
Figure 2.
Figure 2.
Disease-specific survival per temporal bone resection and all 37 cases.
Figure 3.
Figure 3.
Disease-specific survival by clinical T stage.
Figure 4.
Figure 4.
Disease-specific survival for clear and positive resection margins.
See this image and copyright information in PMC

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