title: Predictors of survival and recurrence after temporal bone resection for cancer.
abstract: BACKGROUND
  The purpose of this study was to identify factors predictive of outcome in patients undergoing temporal bone resection (TBR) for head and neck cancer.
  
  
  METHODS
  This was a retrospective study of 72 patients undergoing TBR. Factors associated with survival and recurrence were identified on multivariable regression.
  
  
  RESULTS
  Most tumors were epithelial (81%), commonly (69%) involving critical structures. Cervical metastases were uncommon (6%). Squamous cell carcinoma (SCC) of the external auditory canal carried a high rate of parotid invasion (25%) and parotid nodal metastases (43%). The 5-year rate of overall survival (OS) was 62%; disease-specific survival (DSS), 70%; recurrence-free survival (RFS), 46%. Factors independently associated with outcome on multivariable analysis were margin status and extratemporal spread of disease to the parotid, mandible, or regional nodes. Recurrence was common (72%) in cT3-4 tumors.
  
  
  CONCLUSIONS
  Margin status and extratemporal disease spread are the strongest independent predictors of survival and recurrence. In SCC of the external auditory canal, high rates of parotid involvement support adjunctive parotidectomy. Risk of recurrence in T3-T4 tumors may support a role for adjuvant therapy.
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. morrisl@mskcc.org
authors.forename: Luc G T
authors.initials: LG
authors.lastname: Morris
authors.forename: Saral
authors.initials: S
authors.lastname: Mehra
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Mark H
authors.initials: MH
authors.lastname: Bilsky
authors.forename: Samuel H
authors.initials: SH
authors.lastname: Selesnick
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013701:Temporal Bone / Q000473:pathology* / Q000601:surgery; D055815:Young Adult