Primary carcinoma involving the petrous temporal bone

Between 1975 and 1985, 29 patients with the diagnosis of carcinoma of the petrous temporal bone were seen at the Princess Margaret Hospital. Twenty-seven carcinomas were graded: 13 were well-differentiated; the remaining 14 were either moderately or poorly differentiated tumors. Fifteen patients were managed with a combination of surgery and radiotherapy, 13 were treated with radiotherapy only, and one patient was treated by surgery alone. Median follow-up time was 6.1 years, and the 5-year actuarial local control and cause-specific survival rates for the entire group were 40% and 50%, respectively. Age greater than 60 years, poor grade of tumor, and involvement of the facial nerve were three significant variables associated with poor outcome. A superior 5-year actuarial local control was achieved with surgery plus postoperative radiotherapy (54%) compared to other treatment approaches. Based on the results from this review, we would continue to recommend a combined modality approach of surgery followed by postoperative radiotherapy in the management of this rare, but life-threatening disease.