title: Treatment and outcome of advanced external auditory canal and middle ear squamous cell carcinoma.
abstract: This is a retrospective study to evaluate the outcomes and complications of combined treatment, surgery with or without adjunctive intraoperative radiotherapy, of locally advanced temporal bone squamous cell carcinoma. A series of 17 patients with locally advanced squamous cell carcinoma of the temporal bone were treated between September 2002 and February 2007. Eleven patients had primary tumors, and 6 patients had recurrences. According to the University of Pittsburgh staging system, 5 patients were stage II (T2 N0), 6 patients were stage III (5, T3 N0 and 1, T1 N1), and 6 patients were stage IV (5, T3 N2b and 1, T4 N0). All patients underwent lateral temporal bone resection and pedicle flap reconstruction. Eight patients received intraoperative and postoperative radiotherapies, 4 patients underwent postoperative radiation alone, whereas 5 patients did not receive any adjunctive treatment. Median follow-up was 29.5 months. No major complications were observed. No patients were found to have residual gross tumor. Disease-free survival was 73.3%, and overall survival was 75.6%. Radical external auditory canal and/or middle ear canal resection is of utmost importance to obtain a good surgical outcome. Postoperative radiotherapy is necessary to obtain good local control; no major adverse effects were observed in the intraoperative radiotherapy patients. The incidence of major complication is minimal after pedicle flap reconstruction.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, National Cancer Institute Regina Elena, Rome, Italy. cristalli@ifo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cristalli
authors.forename: Valentina
authors.initials: V
authors.lastname: Manciocco
authors.forename: Barbara
authors.initials: B
authors.lastname: Pichi
authors.forename: Laura
authors.initials: L
authors.lastname: Marucci
authors.forename: Giorgio
authors.initials: G
authors.lastname: Arcangeli
authors.forename: Stefano
authors.initials: S
authors.lastname: Telera
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spriano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D018572:Disease-Free Survival; D004424:Ear Canal / Q000528:radiation effects / Q000601:surgery*; D004428:Ear Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D004432:Ear, Middle / Q000528:radiation effects / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery; D009367:Neoplasm Staging; D010369:Pectoralis Muscles / Q000637:transplantation; D018714:Radiotherapy, Adjuvant; D011882:Radiotherapy, High-Energy; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016038:Skin Transplantation; D012888:Skull Neoplasms / Q000532:radiotherapy / Q000601:surgery; D013524:Surgical Flaps; D015996:Survival Rate; D013701:Temporal Bone / Q000528:radiation effects / Q000601:surgery; D013703:Temporal Muscle / Q000637:transplantation; D016896:Treatment Outcome