Squamous cell carcinoma of the temporal bone: clinical outcomes from radical surgery and postoperative radiotherapy.
OBJECTIVE
To review the treatment of squamous carcinoma of the temporal bone at a regional skull base unit for the period 1982-2012.


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
Sixty patients with primary squamous carcinoma of the temporal bone.


METHODS
Multidisciplinary team approach including surgical resection, reconstruction, and postoperative radiotherapy.


METHODS
Disease-specific survival, overall survival.


RESULTS
The 5-year disease-specific survival for the whole cohort was 44% (CI, 37%-51%). Multivariable analysis revealed nodal status, poorly differentiated squamous cell histology, and carotid involvement to be poor prognostic indicators.


CONCLUSIONS
Although the survival figures in this series are comparable with the best outcomes from other units, our experience would suggest improvements can still be achieved by reconsidering the selection of patients for neck dissection and temperomandibular joint excision in early stage disease. We also conclude that postoperative radiotherapy should be delivered to all patients, including surgical salvage cases who may have received previous irradiation. Finally, the minority of patients with poor prognostic features should be offered a more palliative therapeutic approach.
*Department of Neuro-otology and Skull Base Surgery, Cambridge University Teaching Hospitals NHS Trust; †School of Clinical Medicine, University of Cambridge; ‡Department of Neuro-otology and Skull Base Surgery, St George's and Kingston Hospitals NHS Trusts; §Department of Oncology, Cambridge University Teaching Hospitals NHS Trust; ∥Department of Oncology, Norfolk & Norwich University Hospital NHS Trust; ¶Department of Oncology, Ipswich Hospital NHS Trust; #Department of Neurosurgery, **Department of Plastic Surgery, and ††Department of Histopathology, Cambridge University Teaching Hospitals NHS Trust, U.K.
Liam
L
Masterson
Maral
M
Rouhani
Neil P
NP
Donnelly
James R
JR
Tysome
Parag
P
Patel
Sarah J
SJ
Jefferies
Tom
T
Roques
Christopher
C
Scrase
Richard
R
Mannion
Robert
R
Macfarlane
David
D
Hardy
Amer
A
Durrani
Richard
R
Price
Alison
A
Marker
Patrick
P
Axon
David A
DA
Moffat
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013701:Temporal Bone / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome