Treatment and Outcomes of Carcinoma of the External and Middle Ear: The Validity of En Bloc Resection for Advanced Tumor

Matoba, Takuma; Hanai, Nobuhiro; Suzuki, Hitomi; Nishikawa, Daisuke; Tachibana, Eiji; Okada, Takeshi; Murakami, Shingo; Hasegawa, Yasuhisa

doi:10.2176/nmc.oa.2017-0133

Cited by 15 publications

(18 citation statements)

References 13 publications

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“…8 Even in advanced stage disease, outcomes seem to be better in those treated surgically than those treated with primary radiation. 11,12 The majority of recurrences seem to occur within the first year posttreatment. 13,14 This is also seen in our data.…”

Section: Discussionmentioning

confidence: 99%

Management of Temporal Bone Malignancy in Ireland

Woods

Naude

O’Sullivan

et al. 2019

J Neurol Surg B Skull Base

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Objectives Lateral temporal bone malignancy remains a challenging rare disease. We report 17 years of multidisciplinary care of these tumors with univariate and multivariate analyses of key prognostic indicators for consideration in contemporary oncological management. Design This is a retrospective cohort study. Setting This is set at a tertiary referral center. Participants All patients presenting with histopathologically newly diagnosed cases of temporal bone malignancy between 2000 and 2017 were included. Main Outcome Measures The main outcome measures are disease-specific and recurrence-free survival rates. Results In this study, 48 cases of temporal bone malignancy were diagnosed. Median age at diagnosis was 69 years (range: 5–88). Fourteen patients were female. Squamous cell carcinoma was the predominant malignancy in 34 cases (71%). Surgical treatment was undertaken in 37 patients. Mean length of follow-up was 32 months (range: 0.7–117). Overall 5-year disease-specific survival was 52.4%, while overall 5-year recurrence-free survival was 53.5%. On univariate analysis, significantly worse survival was seen in females (p = 0.008), those with distant metastatic disease (p = 0.041), and in middle ear involvement (p = 0.012) with no difference for involvement of the external auditory canal (p = 0.98) or mastoid (p = 0.78). Only middle ear involvement remained significant on multivariate analysis. Conclusion A wide variety of malignant pathology may present in the temporal bone. Recurrence-free survival is equivalent to international data; however, this figure is low. This emphasizes the need to treat these tumors appropriately with radical resection, where possible, at first presentation. Therefore, multidisciplinary surgical input is recommended. Middle ear involvement was a negative prognosticator for disease-specific and recurrence-free survivals.

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Section: Discussionmentioning

confidence: 99%

Management of Temporal Bone Malignancy in Ireland

Woods

Naude

O’Sullivan

et al. 2019

J Neurol Surg B Skull Base

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“…The nine articles (4,(12)(13)(14)(15)(16)(17)(18)(19) that satisfied the criteria for inclusion in the systematic review and meta-analysis were retrospective case series published between 2009 and 2018. All the studies focused on management of squamous cell carcinoma of the temporal bone.…”

Section: Demographicsmentioning

confidence: 99%

“…All the studies focused on management of squamous cell carcinoma of the temporal bone. Patient demographics were only available in six studies (4,(12)(13)(14)(15)18). The total population of the included studies was 907 patients, 388 of whom had squamous cell carcinoma.…”

Section: Demographicsmentioning

confidence: 99%

Prevalence of occult nodal metastases in squamous cell carcinoma of the temporal bone: A systematic review and meta-analysis

Borsetto

Vijendren

Franchin

et al. 2021

Preprint

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Objectives : Primary : To determine the rate of occult cervical metastasis in primary temporal bone squamous cell carcinomas (TBSSC). Secondary : to perform a subgroup meta-analysis of the risk of occult metastasis based on the clinical stage of the tumour and its risk based on corresponding levels of the neck Design : A systematic review and meta-analysis of papers searched through Medline, Cochrane, Embase, Scopus and Web of Science up to January 2021 to determine the pooled rate of occult lymph node/parotid metastases. Quality assessment of the included studies was assessed through the Newcastle-Ottawa scale. Setting : Centres around the world that perform surgery for TBSCC Participants : Patients with TBSCC Results : Overall, 9 out of 1034 screened studies met the inclusion criteria, for a total of 907 patients of which 388 had TBSCC. Out of the 191 patients who underwent a neck dissection, 21 had positive lymph nodes giving a pooled rate of occult metastases of 11% (95% CI: 7%-17%). When analysed using the Modified Pittsburg staging system, 21 pT2 cases had a pooled occult metastases rate of 3% (95% CI: 0%-21%), 27 pT3 cases had a pooled occult metastases rate of 12% (95% CI: 1%-60%), and 65 pT4 cases had a pooled occult metastases rate of 14% (95% CI: 7%-25%). Data available showed that most of the positive nodes were in Level II. Conclusion: The rate of occult cervical metastases in TBSCC increases based on the tumour (T) staging of the disease with majority of nodal disease found in level 2 of the neck.

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“…Surgery is the mainstay of treatment for early stage EACC (9). Radiotherapy is indicated in the following cases: i) Radical treatment for patients unable to undergo surgery, ii) postoperative treatment for patients who have undergone surgical resection, but having a high risk of recurrence (e.g., positive margins and locally advanced cases), and iii) preoperative treatment for medically operable and locally advanced cases.…”

Section: Introductionmentioning

confidence: 99%