Squamous cell carcinoma of the temporal bone: outcomes of radical surgery and postoperative radiotherapy.

OBJECTIVES/HYPOTHESIS: To analyze the treatment outcomes for squamous cell carcinoma (SCC) of the temporal bone and to identify factors that may influence prognosis.

STUDY DESIGN

Retrospective case series.

METHODS

Case notes review of patients with histologically proven SCC of the temporal bone who had treatment with a curative intent at a tertiary referral center in the Northwest of England, United Kingdom.

RESULTS

A total of 35 patients were treated in this unit over a 12-year period. The most common presentation was otorrhoea, which was present in all patients, followed by otalgia (66%), bleeding (54%), and facial palsy (46%). The overall survival for this series was 48.6%. There were four patients with stage I tumor, and one case each of stage II and stage III disease. The disease-free survival for patients with stage I to stage III disease in this series was 100%. The remaining 29 patients (84%) had stage IV disease, with an overall survival in this group of 41.4%. The average survival period of the 18 patients who succumbed to local disease was 9.2 months (range 3-22). Poorly differentiated SCC was associated with significantly poorer survival (P < 0.05) when compared to well and moderately differentiated SCC. Parotid involvement of SCC, node-positive neck, and the presence of preoperative facial palsy was not associated with poorer survival outcomes.

CONCLUSIONS

SCC of the temporal bone is a highly malignant disease that is associated with high morbidity and mortality despite aggressive multimodal treatment.

LEVEL OF EVIDENCE