累及颞骨的皮肤鳞状细胞癌的流行病学和治疗结果。
Epidemiology and treatment outcomes of cutaneous squamous cell carcinoma extending to the temporal bone.
机构信息
Queensland Skull Base Unit and Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
出版信息
Head Neck. 2022 Dec;44(12):2727-2743. doi: 10.1002/hed.27185. Epub 2022 Sep 9.
BACKGROUND
Accurate epidemiological and outcomes data regarding cutaneous squamous cell carcinoma (cSCC) extending to the temporal bone is lacking.
METHODS
Retrospective analysis of 167 Australian patients with primary and peri-temporal bone cSCC.
RESULTS
cSCC extending from secondary subsites (93.4%) was 14 times more frequent than primary temporal bone SCC (6.6%). For patients who underwent curative surgery ± post-operative radiotherapy (n = 146, 87.4%), 5-year disease-free survival, locoregional recurrence-free survival, disease-specific survival, and overall survival was 53.0%, 59.4%, 67.9%, and 44.7%, respectively. External ear and pre-auricular tumors, salvage surgery, tumor size (≥40 mm medial-lateral), nodal disease, and involved margins were negative predictors of survival in multivariable analysis.
CONCLUSION
In regions of high sun exposure, cSCCs extending to the temporal bone are more common than primary cancers. Outcomes are improved with clear margins, justifying the need for radical resection. Further research regarding pre-auricular cancers is required given poorer associated survival outcomes.
背景
关于扩展至颞骨的皮肤鳞状细胞癌（cSCC）的准确流行病学和结局数据尚缺乏。
方法
回顾性分析了 167 例原发性和颞骨旁皮肤鳞状细胞癌澳大利亚患者。
结果
从次要部位扩展的 cSCC（93.4%）比原发性颞骨 SCC（6.6%）更为常见。对于接受根治性手术±术后放疗的患者（n=146，87.4%），5 年无疾病生存率、局部区域无复发生存率、疾病特异性生存率和总生存率分别为 53.0%、59.4%、67.9%和 44.7%。多变量分析显示，外耳和耳前肿瘤、挽救性手术、肿瘤大小（≥40mm 内外径）、淋巴结疾病和受累切缘是生存的负性预测因素。
结论
在阳光照射强烈的地区，扩展至颞骨的 cSCC 比原发性癌症更为常见。明确的切缘可改善预后，因此需要进行根治性切除。鉴于较差的相关生存结果，需要进一步研究耳前癌。
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