title: Recurrent squamous cell carcinoma of the temporal bone: critical analysis of cases with a poor prognosis.
abstract: OBJECTIVE
  Temporal bone squamous cell carcinoma (TBSCC) is an uncommon, aggressive malignancy with a significant recurrence rate. We reviewed our experience with recurrent TBSCCs.
  
  
  METHODS
  Clinicopathological and therapeutic variables potentially associated with disease-free survival (DFS) and disease-specific survival (DSS) were assessed in 17 TBSCC patients who died of their disease after treatment.
  
  
  RESULTS
  TBSCC recurrences were treated with surgery in 12 cases (palliative in 11, with curative intent in 1) and palliative chemotherapy in 5; the median DFS and DSS were 6 and 16 months, respectively. The mean DFS and DSS were longer in patients who had primary lateral temporal bone resection (LTBR) rather than subtotal temporal bone resection (STBR) (p=0.0173 and p=0.03, respectively). Patients given non-surgical palliative treatment for recurrences had a longer mean DSS than those who underwent surgery (trend toward significance, p=0.09).
  
  
  CONCLUSIONS
  Our results reflect the aggressive nature of TBSCC recurrences. Our findings seem to support the use of non-surgical treatments (chemotherapy, radiotherapy, or specialist palliative care) in patients with loco-regionally advanced recurrent TBSCC. Salvage surgery might be considered for early recurrences when radicality is still achievable. Precise guidelines for the rational follow-up of surgically-treated TBSCCs need to be shared between tertiary centers.
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Zanoletti
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy. Electronic address: gino.marioni@unipd.it.
authors.forename: Gino
authors.initials: G
authors.lastname: Marioni
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Franchella
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lovato
authors.affiliation: Department of Medicine DIMED, Padova University, Padova, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martini
authors.affiliation: Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy; (formerly) ENT Unit, Ospedali Riuniti Bergamo, Bergamo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Mazzoni
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D012888:Skull Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D013701:Temporal Bone; D016896:Treatment Outcome