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. 2022 Dec;44(12):2727-2743.
doi: 10.1002/hed.27185. Epub 2022 Sep 9.

Epidemiology and treatment outcomes of cutaneous squamous cell carcinoma extending to the temporal bone

Michael J C Schachtel  1   2 , Mitesh Gandhi  3 , James J Bowman  1 , Sandro V Porceddu  2   4 , Benedict J Panizza  1   2
Affiliations

Epidemiology and treatment outcomes of cutaneous squamous cell carcinoma extending to the temporal bone

Michael J C Schachtel et al. Head Neck. 2022 Dec.

Abstract

Background: Accurate epidemiological and outcomes data regarding cutaneous squamous cell carcinoma (cSCC) extending to the temporal bone is lacking.

Methods: Retrospective analysis of 167 Australian patients with primary and peri-temporal bone cSCC.

Results: cSCC extending from secondary subsites (93.4%) was 14 times more frequent than primary temporal bone SCC (6.6%). For patients who underwent curative surgery ± post-operative radiotherapy (n = 146, 87.4%), 5-year disease-free survival, locoregional recurrence-free survival, disease-specific survival, and overall survival was 53.0%, 59.4%, 67.9%, and 44.7%, respectively. External ear and pre-auricular tumors, salvage surgery, tumor size (≥40 mm medial-lateral), nodal disease, and involved margins were negative predictors of survival in multivariable analysis.

Conclusion: In regions of high sun exposure, cSCCs extending to the temporal bone are more common than primary cancers. Outcomes are improved with clear margins, justifying the need for radical resection. Further research regarding pre-auricular cancers is required given poorer associated survival outcomes.

Keywords: cutaneous squamous cell carcinoma; perineural spread; radiation therapy; skull base surgery; temporal bone.

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Conflict of interest statement

The author declares that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Figures

FIGURE 1
FIGURE 1
Flowchart of the study cohort. Abbreviations: VII PNS, facial nerve perineural spread; cSCC, cutaneous squamous cell carcinoma
FIGURE 2
FIGURE 2
A patient with a right metastatic parotid cutaneous squamous cell carcinoma extending into the conchal bowl and external auditory canal (A–C) (red arrows). Surgical resection (D) involved partial pinnectomy, lateral temporal bone resection, radical parotidectomy, ascending mandibulectomy, infratemporal fossa resection, and modified radical neck dissection. Reconstruction involved an anterolateral thigh free flap and static slings. The lateral (E) and medial (F) aspects of the excised specimen are provided (tie placed on facial nerve) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Survival outcomes for patients treated with curative intent surgery with or without post‐operative radiotherapy (n = 146) [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Disease‐free survival by subsite of tumor origin in curative intent surgical cases (n = 146). Abbreviations: LN, lymph node; VII, facial nerve; PNS, perineural spread; EAC, external auditory canal [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 5
FIGURE 5
Disease‐free survival in curative intent surgical patients (n = 146), stratified by (A) subsite, (B) radiological medial‐lateral tumor dimension, (C) salvage surgery, (D) surgical margin, and (E) pathological nodal disease (pN). Note: p values calculated using log‐rank testing [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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