University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA.
Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Otolaryngol Head Neck Surg. 2023 Feb;168(2):154-164. doi: 10.1177/01945998221084912.
Temporal bone squamous cell carcinoma (TBSCC) is rare and often confers a poor prognosis. The aim of this study was to synthesize survival and recurrence outcomes data reported in the literature for patients who underwent temporal bone resection (TBR) for curative management of TBSCC. We considered TBSCC listed as originating from multiple subsites, including the external ear, parotid, and external auditory canal (EAC), or nonspecifically from the temporal bone.
PubMed, Cochrane Library, Embase, and manual search of bibliographies.
A systematic literature review conducted in December 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Survival data were collected from 51 retrospective studies, resulting in a pooled cohort of 501 patients with TBSCC. Compared to patients undergoing lateral TBR (LTBR), patients undergoing subtotal (SBTR) or total (TTBR) TBR exhibited significantly higher rates of stage IV disease (P < .001), positive surgical margins (P < .001), facial nerve involvement (P < .001), and recurrent disease (P < .001). A meta-analysis of 15 studies revealed a statistically significant 97% increase in mortality in patients who underwent STBR or TTBR. On multivariate analysis, recurrent disease was independently associated with worse overall survival (P < .001). On univariate analysis, facial nerve involvement was also associated with decreased overall survival (P < .001).
Recurrent disease was associated with risk of death in patients undergoing TBR. Larger prospective multi-institutional studies are needed to ascertain prognostic factors for a wider array of postoperative outcomes, including histology-specific survival and recurrence outcomes.
颞骨鳞状细胞癌（TBSCC）较为罕见，且预后通常较差。本研究旨在综合分析文献中报道的接受颞骨切除术（TBR）治疗 TBSCC 的患者的生存和复发结局数据。我们将 TBSCC 视为源自多个部位的癌症，包括外耳、腮腺和外耳道（EAC），或未明确源自颞骨的癌症。
PubMed、Cochrane 图书馆、Embase 以及文献目录的手动检索。
根据系统评价和荟萃分析的首选报告项目指南，于 2020 年 12 月进行了系统文献复习。
从 51 项回顾性研究中收集了生存数据，最终纳入了 501 例 TBSCC 患者的汇总队列。与接受外侧 TBR（LTBR）的患者相比，接受次全 TBR（SBTR）或全 TBR（TTBR）的患者更常患有 IV 期疾病（P <.001）、切缘阳性（P <.001）、面神经受累（P <.001）和疾病复发（P <.001）。15 项研究的荟萃分析显示，接受 STBR 或 TTBR 的患者死亡率显著增加了 97%。多变量分析显示，疾病复发与总生存较差独立相关（P <.001）。单变量分析显示，面神经受累也与总生存降低相关（P <.001）。
疾病复发与 TBR 后患者的死亡风险相关。需要进行更大规模的前瞻性多机构研究，以确定更广泛的术后结局（包括组织学特异性生存和复发结局）的预后因素。
