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Squamous cell carcinoma of the temporal bone

Published online by Cambridge University Press:  07 January 2008

A G Bibas
Affiliation:
Skull Base Unit, Department of Otorhinolaryngology & Head and Neck Surgery, Guy's Hospital, London, UK Royal National Hospital for Neurology & Neurosurgery, London, UK Department of Otorhinolaryngology & Head and Neck Surgery, Hippokrateion Hospital, University of Athens Medical School, Greece
V Ward
Affiliation:
Skull Base Unit, Department of Otorhinolaryngology & Head and Neck Surgery, Guy's Hospital, London, UK Royal National Hospital for Neurology & Neurosurgery, London, UK
M J Gleeson*
Affiliation:
Skull Base Unit, Department of Otorhinolaryngology & Head and Neck Surgery, Guy's Hospital, London, UK Royal National Hospital for Neurology & Neurosurgery, London, UK
*
Address for correspondence: Professor Michael J Gleeson, Department of Otolaryngology – Head & Neck Surgery, Guy's Hospital, St Thomas Street, London SE1 9RT, UK. Fax: +44 20 71882206 E-mail: [email protected]

Abstract

Objective:

The aim of this study was to present the management and survival data of patients with squamous cell carcinoma of the temporal bone, and to discuss whether extensive surgery improves survival.

Patients and methods:

Retrospective, case-series review of 17 patients (18 cases) with temporal bone carcinoma (15 primary and three recurrent tumours), over a period of 20 years.

Setting:

Tertiary referral centre – university hospital.

Main outcome measures:

Disease-specific and overall five-year survival.

Results:

The mean age at presentation was 63 years, with a range of 39 to 75 years. Twelve cases of de novo tumour were managed by surgical resection followed by adjuvant radiotherapy in 10 cases, while three such patients were considered incurable from the outset and were given a combination of radiotherapy and chemotherapy. Of the three patients referred to our unit with recurrent disease, two were treated elsewhere with radical mastoidectomy and one with chemoradiation; all were subsequently managed by subtotal petrosectomy. The disease-specific and overall five-year survival for the entire cohort was 64.17 per cent (mean 89 months; 95 per cent confidence interval, 62–117) and 47.06 per cent (mean 70 months; 95 per cent confidence interval, 43–98), respectively. The disease-specific and overall survival for patients with advanced T3 and T4 tumours was 59 per cent (mean 83 months; 95 per cent confidence interval, 53–113) and 40 per cent (mean 62; 95 per cent confidence interval, 33–91 months), respectively. All but one recurrence developed within 12 months of initiating treatment. No deaths occurred after 26 months of follow up.

Conclusions:

A lateral temporal bone resection is adequate treatment for T1 and T2 tumours. Post-operative radiotherapy should probably be offered for large T2 tumours. For T3 and T4 tumours, a subtotal petrosectomy with parotidectomy followed by post-operative radiotherapy is adequate treatment, as it offers a similar outcome to that of more extensive procedures.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Morton, RP, Stell, PM, Derrick, PP. Epidemiology of cancer of the middle ear cleft. Cancer 1984;53:1612–173.0.CO;2-P>CrossRefGoogle ScholarPubMed
2 Kuhel, WI, Hume, CR, Selesnick, SH. Cancer of the external auditory canal and temporal bone. Otolaryngol Clin North Am 1996;29:827–52Google ScholarPubMed
3 Moffat, DA, Grey, P, Ballagh, RH, Hardy, DG. Extended temporal bone resection for squamous cell carcinoma. Otolaryngol Head Neck Surg 1997;116:617–23CrossRefGoogle ScholarPubMed
4 Manolidis, S, Pappas, D Jr, Von, DP, Jackson, CG, Glasscock, ME 3rd. Temporal bone and lateral skull base malignancy: experience and results with 81 patients. Am J Otol 1998;19 (Suppl 1):S1–15Google ScholarPubMed
5 Prasad, S, Janecka, IP. Efficacy of surgical treatments for squamous cell carcinoma of the temporal bone: a literature review. Otolaryngol Head Neck Surg 1994;110:270–80CrossRefGoogle ScholarPubMed
6 Arriaga, M, Curtin, H, Takahashi, H, Hirsch, BE, Kamerer, DB. Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings. Ann Otol Rhinol Laryngol 1990;99:714–21CrossRefGoogle ScholarPubMed
7 Hirsch, BE. Staging system revision. Arch Otolaryngol Head Neck Surg 2002;128:93–4Google ScholarPubMed
8 Bibas, A, Ward, VW, Gleeson, M. Bilateral squamous cell carcinomas of the temporal bone. Skull Base 2006;16:213–18CrossRefGoogle Scholar
9 Stell, PM. Carcinoma of the external auditory meatus and middle ear. Clin Otolaryngol Allied Sci 1984;9:281–99CrossRefGoogle ScholarPubMed
10 Arriaga, M, Hirsch, BE, Kamerer, DB, Myers, EN. Squamous cell carcinoma of the external auditory meatus (canal). Otolaryngol Head Neck Surg 1989;101:330–7CrossRefGoogle ScholarPubMed
11 Clark, LJ, Narula, AA, Morgan, DA, Bradley, PJ. Squamous carcinoma of the temporal bone: a revised staging. J Laryngol Otol 1991;105:346–8CrossRefGoogle ScholarPubMed
12 Austin, JR, Stewart, KL, Fawzi, N. Squamous cell carcinoma of the external auditory canal. Therapeutic prognosis based on a proposed staging system. Arch Otolaryngol Head Neck Surg 1994;120:1228–32CrossRefGoogle ScholarPubMed
13 Moody, SA, Hirsch, BE, Myers, EN. Squamous cell carcinoma of the external auditory canal: an evaluation of a staging system. Am J Otol 2000;21:582–8Google ScholarPubMed
14 Moffat, DA, Wagstaff, SA. Squamous cell carcinoma of the temporal bone. Curr Opin Otolaryngol Head Neck Surg 2003;11:107–11CrossRefGoogle ScholarPubMed
15 Nyrop, M, Grontved, A. Cancer of the external auditory canal. Arch Otolaryngol Head Neck Surg 2002;128:834–7CrossRefGoogle ScholarPubMed
16 Lewis, JS. Temporal bone resection. Review of 100 cases. Arch Otolaryngol 1975;101:23–5CrossRefGoogle ScholarPubMed
17 Lewis, JS. Surgical management of tumors of the middle ear and mastoid. J Laryngol Otol 1983;97:299311CrossRefGoogle ScholarPubMed
18 Kinney, SE, Wood, BG. Malignancies of the external ear canal and temporal bone: surgical techniques and results. Laryngoscope 1987;97:158–64CrossRefGoogle ScholarPubMed
19 Pensak, ML, Gleich, LL, Gluckman, JL, Shumrick, KA. Temporal bone carcinoma: contemporary perspectives in the skull base surgical era. Laryngoscope 1996;106:1234–7CrossRefGoogle ScholarPubMed
20 Zhang, B, Tu, G, Xu, G, Tang, P, Hu, Y. Squamous cell carcinoma of temporal bone: reported on 33 patients. Head Neck 1999;21:461–63.0.CO;2-L>CrossRefGoogle ScholarPubMed
21 Golding-Wood, DG, Quiney, RE, Cheesman, AD. Carcinoma of the ear: retrospective analysis of 61 patients. J Laryngol Otol 1989;103:653–6CrossRefGoogle ScholarPubMed
22 Goodwin, WJ, Jesse, RH. Malignant neoplasms of the external auditory canal and temporal bone. Arch Otolaryngol 1980;106:675–9CrossRefGoogle ScholarPubMed
23 Graham, MD, Sataloff, RT, Kemink, JL, Wolf, GT, McGillicuddy, JE. Total en bloc resection of the temporal bone and carotid artery for malignant tumors of the ear and temporal bone. Laryngoscope 1984;94:528–33CrossRefGoogle ScholarPubMed
24 Michaels, L, Wells, M. Squamous cell carcinoma of the middle ear. Clin Otolaryngol Allied Sci 1980;5:235–48CrossRefGoogle ScholarPubMed
25 Nakagawa, T, Kumamoto, Y, Natori, Y, Shiratsuchi, H, Toh, S, Kakazu, Y et al. Squamous cell carcinoma of the external auditory canal and middle ear: an operation combined with preoperative chemoradiotherapy and a free surgical margin. Otol Neurotol 2006;27:242–8CrossRefGoogle Scholar