Temporal bone carcinoma: Novel prognostic score based on clinical and histological features

Abstract

Background: This study aimed to develop a novel temporal bone squamous cell carcinoma (TBSCC) prognosis scoring system and compare it with the revised Pittsburgh staging system. Methods: Forty-four consecutive TBSCC patients were assessed to identify predictors of recurrence. Each predictor's hazard ratio for recurrence was used to develop our novel scoring system. Results: Based on variables with P < .10 in Cox's regression model, our score included: revised Pittsburgh stage; non-anterior spread of T4 carcinoma; dural involvement; and histological grade. A higher recurrence rate (P = .000) and shorter disease-free survival (P = .000) were associated with scores of ≥5. The area under the curve of our score was larger than that of the revised Pittsburgh stage for both recurrence and disease-specific mortality (P = .0178 and P = .0193, respectively). Conclusion: Our TBSCC scoring system is based on variables that are obtainable preoperatively from clinical and radiological data and biopsies. Its prognostic value should be validated for published TBSCC series and then in prospective settings.

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

“…Zanoletti et al also suggest a prognosis scoring system for T4 tumours, including dural involvement and histological grade as negative prognosticators. In addition, the site of tumour origin and direction of tumour extension seem to play a role, as T3 and T4 tumours growing from the external auditory canal into the mastoid and petrous bone seem to have worse prognosis than T3 and T4 tumours originating from the anterior wall of the canal extending into the parotid space 28 .…”

Reply to Letter to the Editor regarding “Temporal bone carcinoma: Novel prognostic score based on clinical and histological features”

“…We read with considerable interest the comments by Nabuurs et al about our recently published study 1 . Certainly, we share with the Dutch research group a deep interest in the study on the temporal bone squamous carcinoma (TBSCC) prognostic factors.…”

Comment on “Temporal bone carcinoma: Novel prognostic score based on clinical and histological features”

“…With great interest we have read the study by Zanoletti et al 1 in which the authors describe the development of a novel prognostic score based on the clinical and histological characteristics of 44 patients with consecutive temporal bone squamous cell carcinoma (TBSCC) treated with primary en bloc surgery to predict recurrence rates and disease-specific mortality.…”

“…6 Given Zanoletti et al's sample size of 44 patients, of whom 20 (45.5%) had a recurrence (i.e., an event), the number of parameters to be estimated in their model should not have exceeded two according to this rule of thumb. Zanoletti et al, 1 however, included seven, that is, "T category according to the revised Pittsburgh staging system" (three parameters to be estimated), "histological grade" (two parameters to be estimated), "dura mater involvement" (one parameter to be estimated), and "nonanterior spread from T4 lesions" (one parameter to be estimated).…”

“…Revised Pittsburgh staging system, clinical, radiological and histological features, novel prognostic score value, and outcome (in terms of disease recurrence) of each patient included in the investigation1 …”