Temporal Bone Resection for Squamous Cell Carcinoma of the Lateral Skull Base: Systematic Review and Meta‐analysis

Abstract

Objective Temporal bone squamous cell carcinoma (TBSCC) is rare and often confers a poor prognosis. The aim of this study was to synthesize survival and recurrence outcomes data reported in the literature for patients who underwent temporal bone resection (TBR) for curative management of TBSCC. We considered TBSCC listed as originating from multiple subsites, including the external ear, parotid, and external auditory canal (EAC), or nonspecifically from the temporal bone. Data Sources PubMed, Cochrane Library, Embase, and manual search of bibliographies. Review Method A systematic literature review conducted in December 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Survival data were collected from 51 retrospective studies, resulting in a pooled cohort of 501 patients with TBSCC. Compared to patients undergoing lateral TBR (LTBR), patients undergoing subtotal (SBTR) or total (TTBR) TBR exhibited significantly higher rates of stage IV disease ( P < .001), positive surgical margins ( P < .001), facial nerve involvement ( P < .001), and recurrent disease ( P < .001). A meta-analysis of 15 studies revealed a statistically significant 97% increase in mortality in patients who underwent STBR or TTBR. On multivariate analysis, recurrent disease was independently associated with worse overall survival ( P < .001). On univariate analysis, facial nerve involvement was also associated with decreased overall survival ( P < .001). Conclusion Recurrent disease was associated with risk of death in patients undergoing TBR. Larger prospective multi-institutional studies are needed to ascertain prognostic factors for a wider array of postoperative outcomes, including histology-specific survival and recurrence outcomes.

Survival Outcomes in Squamous Cell Carcinoma of the External Auditory Canal: A Systematic Review and Meta-Analysis

“…Recently, McCracken et al [ 36 ] published a systematic review on patients with TBSCC who underwent temporal bone resection (TBR) with curative intent.…”

Role of the otologist/neurotologist in managing auricular and periauricular cutaneous malignancies: A 10‐year otologic oncology experience

“…Though treatment of cancers involving the temporal bone and skull base are described in the literature, there are few reports of an otologist's experience treating tumors involving auricular and periauricular soft tissues as well as the temporal bone. [12][13][14] Gidley and colleagues have previously highlighted the importance of an otologic surgeon's involvement in treating a series of 157 patients with primary tumors of the periauricular skin, parotid gland, ear canal, external ear, and skull base. 12 Here, we describe a large series of 387 patients with auricular and periauricular cutaneous, temporal bone, and parotid gland malignancies treated by a single fellowship-trained neurotologist over a span of approximately 10 years from August 2012 to November 2022.…”

“…While collaboration with additional surgical specialists may be necessary in some cases, otologists may certainly be able to provide much of the required surgical care for patients with auricular or periauricular cutaneous malignancies. Though treatment of cancers involving the temporal bone and skull base are described in the literature, there are few reports of an otologist's experience treating tumors involving auricular and periauricular soft tissues as well as the temporal bone 12–14 . Gidley and colleagues have previously highlighted the importance of an otologic surgeon's involvement in treating a series of 157 patients with primary tumors of the periauricular skin, parotid gland, ear canal, external ear, and skull base 12 …”

Clinical outcomes of temporal bone squamous cell carcinoma: A single‐institution experience

“…Temporal bone carcinomas (TBCs) account for a small portion (0.2%) of all malignancies of the head and neck region, with an estimated annual incidence of 1–6 cases per million population. 1 , 2 Primary TBCs are highly heterogeneous carcinomas of varying origins, with the external auditory canal (EAC) and middle ear (ME) being the most commonly involved primary sites and squamous cell carcinoma predominating among all histological types. 3 , 4 …”

“…Temporal bone carcinomas (TBCs) account for a small portion (0.2%) of all malignancies of the head and neck region, with an estimated annual incidence of 1-6 cases per million population. 1,2 Primary TBCs are highly het erogeneous carcinomas of varying origins, with the ex ternal auditory canal (EAC) and middle ear (ME) being the most commonly involved primary sites and squa mous cell carcinoma predominating among all histolog ical types. 3,4 Temporal bone squamous cell carcinoma (TBSCC) typically causes nonspecific symptoms such as otalgia, otorrhea, and hearing loss, making it difficult for clini cians to discriminate TBSCC from inflammatory dis eases.…”