Evaluation of the modified <scp>Pittsburgh</scp> classification for predicting the disease‐free survival outcome of squamous cell carcinoma of the external auditory canal

Nabuurs, Cindy H.; Kievit, Wietske; Labbé, Nilou; Leemans, C. René; Smit, Conrad F.; Brekel, Michiel W. M. van den; Pauw, Robert Jan; Laan, Bernard F. A. M. van der; Jansen, Jeroen C.; Lacko, Martin; Braunius, W.W.; Morita, Shinya; Wierzbicka, Małgorzata; Matoba, Takuma; Hanai, Nobuhiro; Takes, Robert P.; Kunst, Henricus P. M.

doi:10.1002/hed.26424

Cited by 17 publications

(20 citation statements)

References 33 publications

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“…A nationwide study by Nabuurs et al evaluated the modified Pittsburgh classification and deemed it acceptable. However, for T4 tumours they suggest a revised classification with other predictive factors such as surgical margins 27 .…”

Section: Discussionmentioning

confidence: 99%

“…A nationwide study by Nabuurs et al evaluated the modified Pittsburgh classification and deemed it acceptable. However, for T4 tumours they suggest a revised classifi- cation with other predictive factors such as surgical margins 27 . Zanoletti et al also suggest a prognosis scoring system for T4 tumours, including dural involvement and histological grade as negative prognosticators.…”

Section: Discussionmentioning

confidence: 99%

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

Smit¹,

Boer²,

Lissenberg‐Witte³

et al. 2021

Acta Otorhinolaryngol Ital

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SUMMARY 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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Smit¹,

Boer²,

Lissenberg‐Witte³

et al. 2021

Acta Otorhinolaryngol Ital

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“…Despite the AJCC attempt to improve the prognostic value of available classifications and the wide diffusion of the revised Pittsburgh staging system, in the present homogeneous series of TBSCC, both systems resulted only acceptable in terms of effectiveness of the discrimination, according to Hosmer–Lemeshow scale 23 . Every effort must be made in an attempt to produce new staging modalities for TBSCC with greater prognostic capacity 27–31 . This appears to be particularly relevant in the pre‐treatment setting, relying on clinical and radiological findings, and on biopsies 28 .…”

Section: Discussionmentioning

confidence: 91%

Primary temporal bone squamous cell carcinoma: Comparing the prognostic value of the American Joint Committee on Cancer TNM classification (8th edition) with the revised Pittsburgh staging system

et al. 2022

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Background Retrospectively considering a temporal bone squamous cell carcinomas (TBSCCs) series, our aim was to compare the predictive power of the American Joint Committee on Cancer (AJCC) staging system (8th edition) with the revised Pittsburgh staging system (rPSS) in terms of disease‐free survival (DFS), disease‐specific survival (DSS), and overall survival (OS). Methods Forty‐three TBSCCs consecutively treated surgically were reviewed. The prognostic performance of AJCC and rPSS was compared. Results The areas under the curves for the prediction of DFS, DSS, and OS did not differ significantly between both staging systems (p = 0.518, p = 0.940, and p = 0.910, respectively). Harrel's C‐indexes for respectively the AJCC and rPSS were 0.76 and 0.70 for DFS, 0.73 and 0.76 for DSS, 0.66 and 0.63 for OS. Conclusion Comparable prognostic accuracy was observed between AJCC and rPSS. Levels of prognostic performance were only acceptable for both systems, according to Hosmer–Lemeshow scale. Further efforts are needed to define new TBSCC staging modalities with higher prognostic reliability.

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“…In both T3 and T4 cases, the limits of tumor extension should be accurately assessed preoperatively through thin-slice contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging [ 29 ]. The bone cutting line can then be carefully considered to achieve negative margin resection ( Figure 7 ).…”

Section: Discussionmentioning

confidence: 99%

Variations of en Bloc Resection for Advanced External Auditory Canal Squamous Cell Carcinoma: Detailed Anatomical Considerations

Komune

Kuga

Miki

et al. 2021

Cancers

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Currently, only lateral temporal bone resection (LTBR) and subtotal temporal bone resection (STBR) are widely utilized for the surgical treatment of advanced squamous cell carcinoma of the external auditory canal (EAC-SCC). However, there are few descriptions of variations on these surgical approaches. This study aimed to elucidate the variations of en bloc resection for advanced EAC-SCC. We dissected the four sides of cadaveric heads to reveal the anatomical structures related to temporal bone resection. From the viewpoint of surgical anatomy, surgical patterns of temporal bone cutting can be divided into four categories: conventional LTBR, extended LTBR, conventional STBR, and modified STBR. Extended LTBR is divided into four types: superior, inferior, anterior, and posterior extensions. Several extension procedures can be combined based on the extension of the tumor. Furthermore, en bloc resection with the temporomandibular joint or glenoid fossa increases the technical difficulty of a surgical procedure because the exposure and manipulation of the petrous segment of the internal carotid artery are limited from the middle cranial fossa. Surgical approaches for advanced SCC of the temporal bone are diverse. They require accurate preoperative evaluation of the tumor extension and preoperative consideration of the exact line of resection to achieve marginal negative resection.

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Evaluation of the modified Pittsburgh classification for predicting the disease‐free survival outcome of squamous cell carcinoma of the external auditory canal

Abstract: Background: Squamous cell carcinoma (SCC) of the external auditory canal (EAC) is a rare disease, which is commonly classified with the modified This work represents an independent research supported by the

Cited by 17 publications

References 33 publications

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

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

Primary temporal bone squamous cell carcinoma: Comparing the prognostic value of the American Joint Committee on Cancer TNM classification (8th edition) with the revised Pittsburgh staging system

Variations of en Bloc Resection for Advanced External Auditory Canal Squamous Cell Carcinoma: Detailed Anatomical Considerations

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