Zanoletti Elisabetta, Marioni Gino, Franchella Sebastiano, Lovato Andrea, Giacomelli Luciano, Martini Alessandro, Mazzoni Antonio
Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy.
Am J Otolaryngol. 2015 May-Jun;36(3):352-5. doi: 10.1016/j.amjoto.2014.12.008. Epub 2014 Dec 24.
Temporal bone squamous cell carcinoma (TBSCC) is an uncommon, aggressive malignancy with a significant recurrence rate. We reviewed our experience with recurrent TBSCCs.
Clinicopathological and therapeutic variables potentially associated with disease-free survival (DFS) and disease-specific survival (DSS) were assessed in 17 TBSCC patients who died of their disease after treatment.
TBSCC recurrences were treated with surgery in 12 cases (palliative in 11, with curative intent in 1) and palliative chemotherapy in 5; the median DFS and DSS were 6 and 16 months, respectively. The mean DFS and DSS were longer in patients who had primary lateral temporal bone resection (LTBR) rather than subtotal temporal bone resection (STBR) (p=0.0173 and p=0.03, respectively). Patients given non-surgical palliative treatment for recurrences had a longer mean DSS than those who underwent surgery (trend toward significance, p=0.09).
Our results reflect the aggressive nature of TBSCC recurrences. Our findings seem to support the use of non-surgical treatments (chemotherapy, radiotherapy, or specialist palliative care) in patients with loco-regionally advanced recurrent TBSCC. Salvage surgery might be considered for early recurrences when radicality is still achievable. Precise guidelines for the rational follow-up of surgically-treated TBSCCs need to be shared between tertiary centers.
颞骨鳞状细胞癌（TBSCC）是一种罕见的侵袭性恶性肿瘤，复发率较高。我们回顾了复发性TBSCC的治疗经验。
对17例治疗后死于该病的TBSCC患者评估了可能与无病生存期（DFS）和疾病特异性生存期（DSS）相关的临床病理及治疗变量。
12例TBSCC复发患者接受了手术治疗（11例为姑息性手术，1例为根治性手术），5例接受了姑息化疗；DFS和DSS的中位数分别为6个月和16个月。接受原发性颞骨外侧切除术（LTBR）而非颞骨次全切除术（STBR）的患者，其平均DFS和DSS更长（分别为p = 0.0173和p = 0.03）。复发时接受非手术姑息治疗的患者，其平均DSS比接受手术治疗的患者更长（有显著趋势，p = 0.09）。
我们的结果反映了TBSCC复发的侵袭性本质。我们的研究结果似乎支持对局部区域进展性复发性TBSCC患者采用非手术治疗（化疗、放疗或专科姑息治疗）。对于仍可实现根治性切除的早期复发患者，可考虑挽救性手术。三级中心之间需要共享关于手术治疗TBSCC合理随访的精确指南。
