Management of squamous cell carcinoma of the temporal bone: long-term results and factors influencing outcomes
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OTOLOGY
Management of squamous cell carcinoma of the temporal bone: long‑term results and factors influencing outcomes Gianluca Piras1,2 · Golda Grinblat3 · Riccardo Albertini4,5 · Vittoria Sykopetrites1,2 · Shi‑Xun Zhong6 · Lorenzo Lauda1,2 · Mario Sanna1,2 Received: 17 February 2020 / Accepted: 15 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Temporal bone squamous cell carcinoma (TBSCC) is a rare, aggressive tumor. Surgery, alone or combined with radiotherapy, represent the mainstay of treatment. To report our experience in the treatment of TBSCC and evaluate the disease-specific survival, identifying the factors influencing this outcome. Materials and methods A retrospective study was performed on 66 patients between 1993 and 2018. Patients were staged according to the University of Pittsburgh-modified TNM staging system. Nine cases (13.6%) were Stage I, 7 cases (10.6%) Stage II, 20 cases (30.3%) Stage III and 30 cases (45.5%) Stage IV. Twenty-four patients underwent lateral temporal bone resection (LTBR) and 42 patients underwent subtotal temporal bone resection (STBR). Results One hundred percent of Stage I and II patients showed no evidence of disease (NED) after a median follow-up of 101 months (range 1–289 months). NED resulted in 88.2% of Stage III (mean follow-up 80.3 months; range 8–257) and 46.4% of stage IV (mean follow-up 50.6 months; range 3–217). Pittsburgh Stage or involvement of mastoid, facial nerve, medial wall of the middle ear, temporomandibular joint and middle fossa dura emerged as negative prognostic factors. The highest mortality rate occurred in the first 2 years after treatment, due to local recurrence. Conclusions Prognosis of TBSCC can be excellent in early stage tumors, employing a LTBR. In more advanced cases, prognosis is poor. STBR with adjuvant radiotherapy represents the treatment of choice, offering acceptable survival rates. Given the rarity of the pathology, many controversies still exist concerning optimal management. Keywords Temporal bone malignancies · Squamous cell carcinoma · Temporal bone
Introduction
* Gianluca Piras [email protected]; [email protected] 1
Department of Otology and Skull Base Surgery, Gruppo Otologico and Mario Sanna Foundation, Via Emmanueli 42, 29121 Piacenza‑Rome, Italy
2
Casa Di Cura “Piacenza” S.P.A., Piacenza, Italy
3
Hillel Yaffe Medical Center, Affiliated to Technion University, Haifa, Israel
4
Department of Otolaryngology, Head and Neck Surgery, Bologna, Italy
5
Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant’Orsola-Malpighi, Bologna, Italy
6
Department of Otolaryngology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
Squamous cell carcinoma of the temporal bone (TBSCC) is a rare tumor with a locally aggressive behavior. With a reported incidence between 1 and 6 cases per million population/year [1], it represents about 0.2% of all head and neck malignancies. Squamous cell carcinoma (SSC) is the m
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