与颞骨鳞状细胞癌复发相关的因素。

Factors associated with recurrence of squamous cell carcinoma involving the temporal bone.

作者信息

McRackan Theodore R, Fang Te-Yung, Pelosi Stanley, Rivas Alejandro, Dietrich Mary S, Wanna George B, Labadie Robert F, Haynes David S, Bennett Marc L

机构信息

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

Ann Otol Rhinol Laryngol. 2014 Apr;123(4):235-9. doi: 10.1177/0003489414524169.

DOI:10.1177/0003489414524169

PMID:24671478

Abstract

OBJECTIVE

This study aimed to better identify factors associated with recurrence of squamous cell carcinoma (SCC) involving the temporal bone.

METHODS

A retrospective study was conducted at a tertiary hospital. Sixty patients who were diagnosed over a 10-year period with SCC involving the temporal bone and underwent surgical resection were analyzed. All patients were staged based on the University of Pittsburgh staging system. Demographic, intraoperative, and pathologic data were analyzed with respect to recurrence.

RESULTS

Thirteen (21.7%) patients were T1, 8 (13.3%) T2, 7 (11.7%) T3, and 32 (53.3%) T4. Eighteen patients (30.0%) recurred in the study period. The mean time to recurrence was 5.8 months. Tumors originating in the skin overlying the parotid gland and the external auditory canal had higher recurrence rates than those from the auricle/postauricular skin and temporal bone (P = .05). Direct parotid and perineural spread accounted for 15.0% of all routes of temporal invasion but resulted in 22.2% of all recurrences (P = .04). Increased N stage was statistically associated with increased risk of recurrence (P = .01). Cervical, as compared to perifacial and parotid, lymph node involvement was associated with increased risk of recurrence (odds ratio = 6.91; 95% confidence interval, 1.11-42.87).

CONCLUSION

We have identified multiple factors that are associated with increased recurrence of SCC involving the temporal bone.

摘要

目的

本研究旨在更好地确定与颞骨鳞状细胞癌（SCC）复发相关的因素。

方法

在一家三级医院进行了一项回顾性研究。分析了60例在10年期间被诊断为颞骨SCC并接受手术切除的患者。所有患者均根据匹兹堡大学分期系统进行分期。对人口统计学、术中及病理数据进行复发相关分析。

结果

13例（21.7%）患者为T1期，8例（13.3%）为T2期，7例（11.7%）为T3期，32例（53.3%）为T4期。18例患者（30.0%）在研究期间复发。复发的平均时间为5.8个月。起源于腮腺上方皮肤和外耳道的肿瘤比起源于耳廓/耳后皮肤和颞骨的肿瘤复发率更高（P = 0.05）。直接侵犯腮腺和神经周围扩散占颞骨侵犯所有途径的15.0%，但导致了所有复发的22.2%（P = 0.04）。N分期增加与复发风险增加在统计学上相关（P = 0.01）。与面周和腮腺淋巴结受累相比，颈部淋巴结受累与复发风险增加相关（比值比 = 6.91；95%置信区间，1.11 - 42.87）。