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Temporal bone carcinoma: Treatment patterns and survival
Author(s) -
Seligman Kristen L.,
Sun Daniel Q.,
Ten Eyck Patrick P.,
Schularick Nathan M.,
Hansen Marlan R.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27877
Subject(s) - medicine , perineural invasion , lymphovascular invasion , temporal bone , proportional hazards model , retrospective cohort study , survival analysis , surgery , oncology , cancer , metastasis
Objectives/Hypothesis Carcinomas of the temporal bone are rare, and appropriate treatment, staging, and survival data are limited. This study evaluates clinical characteristics and survival rates for patients with temporal bone carcinoma treated with resection at a single tertiary‐care institution, with a focus on the outcomes of patients with locally advanced disease including skull base and/or dural invasion. Study Design Retrospective chart review. Methods Demographic, tumor‐specific, and survival data were collected for patients with primary carcinomas of the external auditory canal with involvement of the temporal bone from 2003 to 2015. All patients were staged according to the modified Pittsburgh system. Kaplan‐Meier and logistic regression analysis were used to calculate factor‐specific survival outcomes. Results Sixty‐seven patients met inclusion criteria; 85% were male. There were 43 squamous cell carcinomas (64%) and 24 basal cell carcinomas (BCCs) (36%). Tumor stage was 24 (36%) T2, 12 (18%) T3, and 31 (46%) T4 tumors; 53% had recurrent disease. Surgical management included 49 lateral temporal bone resections and 18 subtotal temporal bone resections. Kaplan‐Meier analyses revealed more favorable 5‐year survival rates associated with BCC histology ( P = .01), lateral temporal bone resection compared to subtotal temporal bone resection ( P < .01), lack of immunocompromise ( P = .04), and absence of perineural/lymphovascular invasion ( P = .01). Multivariate regression analysis did not yield statistically significant results. Conclusions Factors predictive of more favorable survival include lack of immunocompromise, BCC histology, absence of perineural/lymphovascular invasion, and disease extent amenable to lateral temporal bone resection. Dural invasion is not an absolute contraindication to surgery, with a subset of patients surviving >5 years. Level of Evidence 3 Laryngoscope , 130:E11–E20, 2020