Prognostic factors for squamous cell carcinoma of the temporal bone: extensive bone involvement or extensive soft tissue involvement?

Abstract

Conclusion:Extensive bone erosion correlated with a worse prognosis of the squamous cell carcinoma (SCC) of the temporal bone but extensive soft tissue involvement did not correlate with prognosis in this study. Resectability of the tumor seems to be major prognostic factors of temporal bone SCC.Objective: Prognostic factors for SCC of the temporal bone were evaluated regarding initial clinical symptoms and radiographic imaging. Methods:Clinical symptoms of the patients with primary SCC of the external auditory canal (EAC) or middle ear (ME) were reviewed based on medical records. Correlation of clinical symptoms and cancer severity staging using the modified Pittsburgh classification was analyzed, along with disease-specific survival (DSS). Results:Sixteen patients with primary SCC of the EAC (n=13) or ME (n=3) were included in the study population. Disease-specific survival was not influenced by whether a hearing disturbance or otalgia was noted at the first medical examination.Extended bone involvement identified with imaging studies significantly correlated with worse prognosis (p<0.05). Prognoses of patients without extensive bone erosion were well and extensive (≥0.5 cm) soft tissue involvement did not correlate with prognosis in this study. Prognoses of patients with insufficient bone resection or no surgery were significantly poor (p<0.01).

Concomitant chemoradiotherapy for advanced squamous cell carcinoma of the temporal bone

“…Reported 5-year overall survival rates for surgically treated patients with T4 tumors range from 17% to 40%. 2,[4][5][6][12][13][14] A meta-analysis of 752 patients with advanced (T3, T4) cancers of the temporal bone 15 reported that 5-year overall survival rates for patients who underwent surgery 6 RT, preoperative chemoradiotherapy (CRT) followed by surgery, definitive CRT, and surgery followed by postoperative CRT were 53.5%, 85.7%, 43.6%, and 0%, respectively. These results suggest that preoperative CRT may lead to improved survival of surgically treated patients and that the effectiveness of definitive CRT may be equivalent to that of surgical resection.…”

Predictors of survival and recurrence after temporal bone resection for cancer

“…The extant literature consists of numerous case series that have reported a wide range of survival data, reflecting differences in the underlying characteristics of cohorts drawn from various institutions. 1,6,[8][9][10][12][13][14][15]18,19,22,24,[30][31][32][33][34][35][36][37][38][39][40][41] Historical survival data can be most readily generalized to clinical practice if factors predictive of outcome can be identified. Several larger series have reported preliminary descriptions of factors influencing survival, based on univariate comparisons.…”

“…Most cohorts have been limited to squamous cell histology, and comprehensive outcomes analyses have been limited. 2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Further complicating analysis, there is no recognized American Joint Committee on Cancer (AJCC) or Union Internationale Contre le Cancer (UICC) staging system for tumors of the external auditory canal/temporal bone, with multiple systems having been proposed. 3,16,25,26 To date, the most widely used system is the University of Pittsburgh staging system, first described in 1990 by Arriaga and colleagues 25 and modified in 2000 by Moody et al 3 Other than Pittsburgh stage and surgical margin status, no other factors have been consistently demonstrated to be associated with outcome, and multivariable analyses of factors affecting outcome have not been reported.…”

Temporal bone carcinoma. Current diagnostic, therapeutic, and prognostic concepts

“…Radiotherapy (Table III) It is well known that the prognosis for patients with TBSCC treated with chemo-radiotherapy (CHT-RT) alone is unsatisfactory [27,32,45]. Only a very few studies found that RT alone produced results comparable with combined surgery and RT [5,67].…”