Clinical Analysis of En Bloc Resection for Advanced Temporal Bone Squamous Cell Carcinoma

Abstract

Objective En bloc and margin-negative surgical resection seems to offer the best prognosis for patients with temporal bone squamous cell carcinoma (TB-SCC). In this study, we summarize the outcomes of surgical cases of advanced TB-SCC (T3–T4) that were managed in two institutions, with an accompanying description of the surgical procedure that was utilized: modified subtotal temporal bone resection (STBR), which involves the en bloc removal of the temporal bone including or transecting the otic capsule.

Design This is a case series study with chart review.

Setting The study was conducted at two academic tertiary care medical centers.

Participants Chart information was collected for all patients who underwent surgical resection of advanced TB-SCC between July 1998 and February 2019. The resulting dataset contained 43 patients with advanced TB-SCC who underwent en bloc resection during the review period. Tumor staging followed the modified Pittsburgh classification. Disease-specific survival (DSS) rates were calculated according to the Kaplan–Meier method.

Main Outcome Measure This study shows disease-specific 5-year DSS rate.

Results The 5-year DSS rate of the cases who underwent en bloc resection was 79.7%. En bloc lateral temporal bone resection was employed in a total of 25 cases (DSS: 79.0%). En bloc modified STBR was utilized in 18 cases (DSS: 81.7%).

Conclusion En bloc margin-negative resection is a reliable treatment strategy for advanced TB-SCC. Modified STBR can be a treatment option for TB-SCC without marked posterior extension.

Keywords

subtotal temporal bone resection - squamous cell carcinoma - temporal bone - skull base

Publikationsverlauf

Eingereicht: 20. Juli 2020

Angenommen: 01. November 2020

Artikel online veröffentlicht:
12. Februar 2021

• References

• 1 Mazzoni A, Zanoletti E, Marioni G, Martini A. En bloc temporal bone resections in squamous cell carcinoma of the ear. Technique, principles, and limits. Acta Otolaryngol 2016; 136 (05) 425-432
• 2 Conley JJ, Novack AJ. The surgical treatment of malignant tumors of the ear and temporal bone. Part I. AMA Arch Otolaryngol 1960; 71: 635-652
• 3 Jimbo H, Kamata S, Miura K. et al. En bloc temporal bone resection using a diamond threadwire saw for malignant tumors. J Neurosurg 2011; 114 (05) 1386-1389
• 4 Parsons H, Lewis JS. Subtotal resection of the temporal bone for cancer of the ear. Cancer 1954; 7 (05) 995-1001
• 5 Dean NR, White HN, Carter DS. et al. Outcomes following temporal bone resection. Laryngoscope 2010; 120 (08) 1516-1522
• 6 Gidley PW, Roberts DB, Sturgis EM. Squamous cell carcinoma of the temporal bone. Laryngoscope 2010; 120 (06) 1144-1151
• 7 Moore MG, Deschler DG, McKenna MJ, Varvares MA, Lin DT. Management outcomes following lateral temporal bone resection for ear and temporal bone malignancies. Otolaryngol Head Neck Surg 2007; 137 (06) 893-898
• 8 Prasad SC, D'Orazio F, Medina M, Bacciu A, Sanna M. State of the art in temporal bone malignancies. Curr Opin Otolaryngol Head Neck Surg 2014; 22 (02) 154-165
• 9 Muelleman T, Chowdhury NI, Killeen D. et al. Effect of piecemeal versus en bloc approaches to the lateral temporal bone on survival outcomes. Otolaryngol Head Neck Surg 2018; 158 (04) 716-720
• 10 Nakagawa T, Kumamoto Y, Natori Y. et al. Squamous cell carcinoma of the external auditory canal and middle ear: an operation combined with preoperative chemoradiotherapy and a free surgical margin. Otol Neurotol 2006; 27 (02) 242-248 , discussion 249
• 11 Moody SA, Hirsch BE, Myers EN. Squamous cell carcinoma of the external auditory canal: an evaluation of a staging system. Am J Otol 2000; 21 (04) 582-588
• 12 Yin M, Ishikawa K, Honda K. et al. Analysis of 95 cases of squamous cell carcinoma of the external and middle ear. Auris Nasus Larynx 2006; 33 (03) 251-257
• 13 Sekhar LN, Pomeranz S, Janecka IP, Hirsch B, Ramasastry S. Temporal bone neoplasms: a report on 20 surgically treated cases. J Neurosurg 1992; 76 (04) 578-587
• 14 Kawahara N, Sasaki T, Asakage T. et al. Long-term outcome following radical temporal bone resection for lateral skull base malignancies: a neurosurgical perspective. J Neurosurg 2008; 108 (03) 501-510
• 15 Kinney SE, Wood BG. Malignancies of the external ear canal and temporal bone: surgical techniques and results. Laryngoscope 1987; 97 (02) 158-164
• 16 Komune N, Komune S, Morishita T, Rhoton Jr AL. Microsurgical anatomy of subtotal temporal bone resection en bloc with the parotid gland and temporomandibular joint. Neurosurgery 2014; 10 (Suppl. 02) 334-356 , discussion 356
• 17 Morris LG, Mehra S, Shah JP, Bilsky MH, Selesnick SH, Kraus DH. Predictors of survival and recurrence after temporal bone resection for cancer. Head Neck 2012; 34 (09) 1231-1239
• 18 Seligman KL, Sun DQ, Ten Eyck PP, Schularick NM, Hansen MR. Temporal bone carcinoma: Treatment patterns and survival. Laryngoscope 2019
• 19 Li W, Zhang T, Dai C. Temporal bone malignancies involving the jugular foramen: diagnosis and management. ORL J Otorhinolaryngol Relat Spec 2014; 76 (04) 227-235
• 20 Mohri M, Nagashima T, Tahara S, Amatsu M. Significance of tubal resection in surgical treatment of middle ear carcinoma. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology -. Head Neck Surg 1997; 254 (04) 208-211