Bibas A G, Ward V, Gleeson M J
Skull Base Unit, Department of Otorhinolaryngology & Head and Neck Surgery, Guy's Hospital, London, UK.
J Laryngol Otol. 2008 Nov;122(11):1156-61. doi: 10.1017/S0022215107001338. Epub 2008 Jan 7.
The aim of this study was to present the management and survival data of patients with squamous cell carcinoma of the temporal bone, and to discuss whether extensive surgery improves survival.
Retrospective, case-series review of 17 patients (18 cases) with temporal bone carcinoma (15 primary and three recurrent tumours), over a period of 20 years.
Tertiary referral centre-university hospital.
Disease-specific and overall five-year survival.
The mean age at presentation was 63 years, with a range of 39 to 75 years. Twelve cases of de novo tumour were managed by surgical resection followed by adjuvant radiotherapy in 10 cases, while three such patients were considered incurable from the outset and were given a combination of radiotherapy and chemotherapy. Of the three patients referred to our unit with recurrent disease, two were treated elsewhere with radical mastoidectomy and one with chemoradiation; all were subsequently managed by subtotal petrosectomy. The disease-specific and overall five-year survival for the entire cohort was 64.17 per cent (mean 89 months; 95 per cent confidence interval, 62-117) and 47.06 per cent (mean 70 months; 95 per cent confidence interval, 43-98), respectively. The disease-specific and overall survival for patients with advanced T3 and T4 tumours was 59 per cent (mean 83 months; 95 per cent confidence interval, 53-113) and 40 per cent (mean 62; 95 per cent confidence interval, 33-91 months), respectively. All but one recurrence developed within 12 months of initiating treatment. No deaths occurred after 26 months of follow up.
A lateral temporal bone resection is adequate treatment for T1 and T2 tumours. Post-operative radiotherapy should probably be offered for large T2 tumours. For T3 and T4 tumours, a subtotal petrosectomy with parotidectomy followed by post-operative radiotherapy is adequate treatment, as it offers a similar outcome to that of more extensive procedures.
本研究旨在呈现颞骨鳞状细胞癌患者的治疗及生存数据，并探讨广泛手术是否能提高生存率。
对17例（18例次）颞骨癌患者（15例原发性肿瘤和3例复发性肿瘤）进行为期20年的回顾性病例系列研究。
三级转诊中心——大学医院。
疾病特异性和总体五年生存率。
患者就诊时的平均年龄为63岁，范围为39至75岁。12例原发性肿瘤患者接受了手术切除，其中10例术后接受辅助放疗，而3例患者从一开始就被认为无法治愈，接受了放疗和化疗联合治疗。在转诊至本单位的3例复发性疾病患者中，2例在其他地方接受了根治性乳突切除术，1例接受了放化疗；所有患者随后均接受了颞骨次全切除术。整个队列的疾病特异性和总体五年生存率分别为64.17%（平均89个月；95%置信区间，62 - 117）和47.06%（平均70个月；95%置信区间，43 - 98）。T3和T4期晚期肿瘤患者的疾病特异性和总体生存率分别为59%（平均83个月；95%置信区间，53 - 113）和40%（平均62个月；95%置信区间，33 - 91个月）。除1例复发外，所有复发均在开始治疗后的12个月内发生。随访26个月后无死亡病例。
颞骨外侧切除术适用于T1和T2期肿瘤。对于较大的T2期肿瘤，可能应提供术后放疗。对于T3和T4期肿瘤，颞骨次全切除术加腮腺切除术并术后放疗是充分的治疗方法，因为其疗效与更广泛的手术相似。
