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Predictors of survival and recurrence after temporal bone resection for cancer
Author(s) -
Morris Luc G. T.,
Mehra Saral,
Shah Jatin P.,
Bilsky Mark H.,
Selesnick Samuel H.,
Kraus Dennis H.
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21883
Subject(s) - medicine , parotidectomy , head and neck cancer , resection margin , adjuvant therapy , parotid gland , retrospective cohort study , neck dissection , cancer , surgery , salivary gland cancer , basal cell , disease , oncology , resection , facial nerve , pathology
Background The purpose of this study was to identify factors predictive of outcome in patients undergoing temporal bone resection (TBR) for head and neck cancer. Methods This was a retrospective study of 72 patients undergoing TBR. Factors associated with survival and recurrence were identified on multivariable regression. Results Most tumors were epithelial (81%), commonly (69%) involving critical structures. Cervical metastases were uncommon (6%). Squamous cell carcinoma (SCC) of the external auditory canal carried a high rate of parotid invasion (25%) and parotid nodal metastases (43%). The 5‐year rate of overall survival (OS) was 62%; disease‐specific survival (DSS), 70%; recurrence‐free survival (RFS), 46%. Factors independently associated with outcome on multivariable analysis were margin status and extratemporal spread of disease to the parotid, mandible, or regional nodes. Recurrence was common (72%) in cT3–4 tumors. Conclusions Margin status and extratemporal disease spread are the strongest independent predictors of survival and recurrence. In SCC of the external auditory canal, high rates of parotid involvement support adjunctive parotidectomy. Risk of recurrence in T3–T4 tumors may support a role for adjuvant therapy. © 2011 Wiley Periodicals, Inc. Head Neck, 2012