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颞骨和外耳道基底细胞癌。

Basal cell carcinoma of the temporal bone and external auditory canal.

作者信息

Breen Joseph T, Roberts Dianna B, Gidley Paul W

机构信息

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

出版信息

Laryngoscope. 2018 Jun;128(6):1425-1430. doi: 10.1002/lary.26785. Epub 2017 Aug 29.

Abstract

OBJECTIVES/HYPOTHESIS: To review the presenting features, treatment, and outcomes for patients with basal cell carcinoma (BCC) involving the temporal bone or external auditory canal (EAC).

STUDY DESIGN

Retrospective case series.

METHODS

Presenting characteristics, treatment strategies, and outcomes for patients with BCC involving the temporal bone or EAC were reviewed. Main outcome measures included rates of overall and disease-free survival at 5 years.

RESULTS

Forty-two patients met the inclusion criteria (mean age, 67 years). The most common presenting symptoms were hearing loss (15 patients, 36%) and otorrhea (11 patients, 26%). The 5-year overall survival rate was 78%, and the 5-year disease-free survival rate was 77%. Patients who had undergone surgery elsewhere and presented with facial weakness had significantly worse overall survival (P = .004). Ten patients (24%) underwent sacrifice of at least a portion of the facial nerve at the time of their initial procedure at our institution. Two patients (5%) developed regional nodal disease. There was a trend toward better disease-free survival for patients who received adjuvant radiation therapy after surgery at our institution (P = .06).

CONCLUSIONS

BCC originating from or extending to the temporal bone can exhibit a wide range of behavior, ranging from superficial lesions readily managed with surgery to extensive locally invasive tumors with propensity for recurrence, treated with multimodality therapy. BCC may be associated with better prognosis than other temporal bone malignancies.

LEVEL OF EVIDENCE

  1. Laryngoscope, 128:1425-1430, 2018.
摘要

目的/假设:回顾累及颞骨或外耳道(EAC)的基底细胞癌(BCC)患者的临床表现、治疗方法及预后。

研究设计

回顾性病例系列研究。

方法

回顾累及颞骨或EAC的BCC患者的临床表现、治疗策略及预后。主要观察指标包括5年总生存率和无病生存率。

结果

42例患者符合纳入标准(平均年龄67岁)。最常见的临床表现为听力减退(15例,36%)和耳漏(11例,26%)。5年总生存率为78%,5年无病生存率为77%。曾在其他地方接受手术且伴有面部无力的患者总生存率显著较差(P = .004)。10例患者(24%)在我院初次手术时至少牺牲了部分面神经。2例患者(5%)出现区域淋巴结转移。在我院接受术后辅助放疗的患者无病生存率有改善趋势(P = .06)。

结论

起源于或扩展至颞骨的BCC可表现出广泛的行为,从易于手术治疗的浅表病变到易复发的广泛局部侵袭性肿瘤,需采用多模式治疗。与其他颞骨恶性肿瘤相比,BCC的预后可能较好。

证据级别

4。《喉镜》,2018年,第128卷,第1425 - 1430页。

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