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Published on: January 5, 2017
Squamous cell carcinoma of the temporal bone: the impact of local control on survival
Antoine Dubray-Vautrin1,2, Benjamin Vérillaud1, Philippe Herman1
1Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Center of Neurosensorial-Head&Neck Diseases, Lariboisière Hospital, University of Paris Cité, Assistance Publique des Hôpitaux de Paris & UMR 1141 Center for the Developing Brain, Paris Biobank BB-0033-00064, Platform of Biopathology and Innovative Technologies for Health, Paris, France.
Background:
Squamous cell carcinoma (SCC) of the temporal bone (TB) is a rare pathology originating from the external auditory canal (EAC). Surgery remains the gold standard to achieve local control.Aims/Objectives:The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) after surgery of the SCC of EAC.
Material And Methods:
A retrospective chart review in a tertiary referral center included 26 patients: 23 were operated with lateral temporal bone resection (LTBR, n = 10) and extended temporal bone resection (ETBR, n = 13). The outcomes were OS and DFS.
Results:
Adjuvant radiotherapy was performed in 91.3% (n = 21/23). Mean age was 60.8 and sex ratio was 1. Median follow-up was 43 months; The 5-years OS was 90% (± 9.5%) and 47.7% (± 12.9%) for stage I/II and III/IV respectively (p = .033). DFS was 67.6% (IC 95%, 51.4%-88.9%) without statistical difference between early advanced stage. Incomplete margins (p = .004) and Stage IV(p < .001) were associated with poorer DFS. Free margins significantly correlated with better OS (HR = 9.8, p = .04).
Conclusion:
En bloc surgical resection with free margins, coupled with postoperative radiotherapy, provides optimal local control. For stage IV tumors, where complete margins are achievable, ETBR is recommended to enhance local control.
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