OUTCOME OF RADICAL SURGERY AND POST-OPERATIVE RADIOTHERAPY FOR SQUAMOUS CARCINOMA OF THE TEMPORAL BONE

David A. Moffat

Department of Neuro-otology and Skull Base Surgery, Addenbrooke’s, Cambridge University Hospital, UK

Objective

To analyze the clinical data and outcome of all the patients treated surgically for squamous carcinoma of the temporal bone in a tertiary referral skull base department over 25 years.

Methods

Fifty-four patients with squamous carcinoma of the temporal bone were analyzed. The patients were staged according to the Pittsburgh system. The surgical technique, reconstruction of the surgical defect, post-operative radio-therapeutic treatment, follow-up regimen and results are all described in detail.

Results

Disease-free survival of T2N0M0 tumors or stage II was 100%. The survival of stage-III disease T3N0M0 was also 100%. Overall T3 tumors resulted in 50% survival since 50% had nodal involvement were stage-IV disease and none of those survived. There was 100% mortality where nodes were involved. There was a 54% survival for T4N0M0 tumors and 45% for T4 tumors overall. The stage-IV tumor survival was 42%.

Conclusion

The overall disease free survival in the whole series was 52%. Node positive disease, poorly differentiated squamous cell histology, brain involvement and salvage surgery were associated with a poorer outcome. The improved survival (66%) of patients treated de novo in this series compared with those treated as salvage (34%) suggests that early referral and aggressive primary surgical treatment with post-operative radiotherapy offers the greatest chance of cure.


Address for correspondence: David A. Moffat, Millington Lodge, 3 Millington Road, Newnham, Cambridge, CB3 9HW, UK. dam26@cam.ac.uk

Cholesteatoma and Ear Surgery – An Update, p. 131

Edited by Haruo Takahashi

2013 © Kugler Publications, Amsterdam, The Netherlands