David A Moffat1, Sherryl A Wagstaff, David G Hardy. 1. Department of Otoneurological and Skull Base Surgery, Addenbrooke's Cambridge University Teaching Hospital NHS Trust, Cambridge CB2 2QQ, UK.
Abstract
OBJECTIVES/HYPOTHESIS: The objective was to analyze the clinical data and outcome of all the patients treated surgically for squamous carcinoma of the temporal bone in a tertiary referral department of skull base surgery over a 20-year period. STUDY DESIGN: Retrospective. METHODS: Thirty-nine patients with squamous carcinoma of the temporal bone were analyzed. The patients were staged according to the University of Pittsburgh system. The surgical technique, reconstruction of the surgical defect, postoperative radiotherapeutic treatment, follow-up regimen, and results were all described in detail. RESULTS: Disease-free survival for T2N0M0 tumors or stage II disease was 100%. The survival for stage III disease was also 100%. Overall, T3 tumors resulted in 50% survival. Overall, survival for stage IV tumors 34.3%, and for T4 tumors, 38%. CONCLUSION: The overall disease-free survival for the entire series was 43.2%. Node-positive disease, poorly differentiated squamous cell histological findings, brain involvement, and salvage surgery were associated with a poorer outcome. The improved survival (66%) of patients treated de novo in the study series compared with those treated with salvage surgery (33%) suggested that early referral and aggressive primary surgical treatment with postoperative radiotherapy offer the greatest chance of cure.
OBJECTIVES/HYPOTHESIS: The objective was to analyze the clinical data and outcome of all the patients treated surgically for squamous carcinoma of the temporal bone in a tertiary referral department of skull base surgery over a 20-year period. STUDY DESIGN: Retrospective. METHODS: Thirty-nine patients with squamous carcinoma of the temporal bone were analyzed. The patients were staged according to the University of Pittsburgh system. The surgical technique, reconstruction of the surgical defect, postoperative radiotherapeutic treatment, follow-up regimen, and results were all described in detail. RESULTS: Disease-free survival for T2N0M0 tumors or stage II disease was 100%. The survival for stage III disease was also 100%. Overall, T3 tumors resulted in 50% survival. Overall, survival for stage IV tumors 34.3%, and for T4 tumors, 38%. CONCLUSION: The overall disease-free survival for the entire series was 43.2%. Node-positive disease, poorly differentiated squamous cell histological findings, brain involvement, and salvage surgery were associated with a poorer outcome. The improved survival (66%) of patients treated de novo in the study series compared with those treated with salvage surgery (33%) suggested that early referral and aggressive primary surgical treatment with postoperative radiotherapy offer the greatest chance of cure.
Authors: Luc G T Morris; Saral Mehra; Jatin P Shah; Mark H Bilsky; Samuel H Selesnick; Dennis H Kraus Journal: Head Neck Date: 2011-09-23 Impact factor: 3.147