Omura Go, Ando Mizuo, Saito Yuki, Fukuoka Osamu, Akashi Ken, Yoshida Masafumi, Kakigi Akinobu, Asakage Takahiro, Yamasoba Tatsuya
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Head and Neck Surgery, Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Int J Clin Oncol. 2017 Jun;22(3):431-437. doi: 10.1007/s10147-016-1076-8. Epub 2017 Jan 2.
Temporal bone squamous cell carcinoma (TSCC) is a rare malignancy. Due to its low incidence rate, studies involving TSCC treatment are limited. The aim of this study is to define the prognostic factors of surgery for TSCC by evaluating our clinical experience.
We reviewed the clinical charts of patients presenting at the University of Tokyo Hospital between 2001 and 2014 and identified 33 patients with TSCC who had been treated with surgery as initial curative treatment.
Lateral and subtotal temporal bone resections were performed in 17 and 16 patients, respectively. The 5-year disease-specific and overall survival rate were 71 and 62%, respectively. The significant poor prognostic factors were pathological T4 (P = 0.03), dural invasion (P = 0.008), temporomandibular joint invasion (P = 0.04), and a positive surgical margin (P = 0.009).
We demonstrated that the outcome of curative surgery for TSCC as initial treatment was favorable. However, because of the difficulty to ensure an adequate or clear surgical margin due to anatomical complexity, the surgical indication for T4 TSCC with temporomandibular joint invasion should be reconsidered.
颞骨鳞状细胞癌（TSCC）是一种罕见的恶性肿瘤。由于其发病率低，涉及TSCC治疗的研究有限。本研究的目的是通过评估我们的临床经验来确定TSCC手术的预后因素。
我们回顾了2001年至2014年在东京大学医院就诊的患者的临床病历，确定了33例接受手术作为初始根治性治疗的TSCC患者。
分别对17例和16例患者进行了颞骨外侧切除术和次全切除术。5年疾病特异性生存率和总生存率分别为71%和62%。显著的不良预后因素为病理T4（P = 0.03）、硬脑膜侵犯（P = 0.008）、颞下颌关节侵犯（P = 0.04）和手术切缘阳性（P = 0.009）。
我们证明了TSCC初始治疗采用根治性手术的结果是良好的。然而，由于解剖结构复杂难以确保足够或清晰的手术切缘，对于伴有颞下颌关节侵犯的T4 TSCC的手术指征应重新考虑。
