TY - JOUR
T1 - Temporal bone carcinoma
T2 - Treatment patterns and survival
AU - Seligman, Kristen L.
AU - Sun, Daniel Q.
AU - Ten Eyck, Patrick P.
AU - Schularick, Nathan M.
AU - Hansen, Marlan R.
N1 - Publisher Copyright:
© 2019 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
KW - Temporal bone carcinoma
KW - basal cell carcinoma
KW - squamous cell carcinoma
KW - temporal bone resection
UR - http://www.scopus.com/inward/record.url?scp=85062957864&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062957864&partnerID=8YFLogxK
U2 - 10.1002/lary.27877
DO - 10.1002/lary.27877
M3 - Article
C2 - 30874314
AN - SCOPUS:85062957864
VL - 130
SP - E11-E20
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 1
ER -