Dubray-Vautrin Antoine, Vérillaud Benjamin, Herman Philippe, Kania Romain
Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Center of Neurosensorial-Head&Neck Diseases, Lariboisière Hospital, University of Paris Cité, Assistance Publique des Hôpitaux de Paris & UMR 1141 Center for the Developing Brain, Paris Biobank BB-0033-00064, Platform of Biopathology and Innovative Technologies for Health, Paris, France.
Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France.
Acta Otolaryngol. 2025 Jan;145(1):23-29. doi: 10.1080/00016489.2024.2311788. Epub 2024 Feb 12.
Squamous cell carcinoma (SCC) of the temporal bone (TB) is a rare pathology originating from the external auditory canal (EAC). Surgery remains the gold standard to achieve local control.Aims/Objectives:The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) after surgery of the SCC of EAC.
A retrospective chart review in a tertiary referral center included 26 patients: 23 were operated with lateral temporal bone resection (LTBR, = 10) and extended temporal bone resection (ETBR, = 13). The outcomes were OS and DFS.
Adjuvant radiotherapy was performed in 91.3% ( = 21/23). Mean age was 60.8 and sex ratio was 1. Median follow-up was 43 months; The 5-years OS was 90% (± 9.5%) and 47.7% (± 12.9%) for stage I/II and III/IV respectively ( = .033). DFS was 67.6% (IC 95%, 51.4%-88.9%) without statistical difference between early advanced stage. Incomplete margins ( = .004) and Stage IV( < .001) were associated with poorer DFS. Free margins significantly correlated with better OS (HR = 9.8, = .04).
En bloc surgical resection with free margins, coupled with postoperative radiotherapy, provides optimal local control. For stage IV tumors, where complete margins are achievable, ETBR is recommended to enhance local control.
颞骨鳞状细胞癌（SCC）是一种起源于外耳道（EAC）的罕见病理类型。手术仍然是实现局部控制的金标准。
本研究的目的是评估外耳道SCC手术后的总生存期（OS）和无病生存期（DFS）。
在一家三级转诊中心进行的回顾性病历审查纳入了26例患者：23例接受了外侧颞骨切除术（LTBR，n = 10）和扩大颞骨切除术（ETBR，n = 13）。观察指标为OS和DFS。
91.3%（n = 21/23）的患者接受了辅助放疗。平均年龄为60.8岁，性别比为1。中位随访时间为43个月；I/II期和III/IV期的5年OS分别为90%（±9.5%）和47.7%（±12.9%）（P = 0.033）。DFS为67.6%（95%CI，51.4%-88.9%），早期和晚期之间无统计学差异。切缘不完整（P = 0.004）和IV期（P < 0.001）与较差的DFS相关。切缘阴性与更好的OS显著相关（HR = 9.8，P = 0.04）。
切缘阴性的整块手术切除，联合术后放疗，可提供最佳的局部控制。对于IV期肿瘤，若能实现切缘阴性，建议行ETBR以加强局部控制。
