The Role of Facial Palsy in Staging Squamous Cell Carcinoma of the Temporal Bone and External Auditory Canal: A Comparative Survival Analysis
The Role of Facial Palsy in Staging Squamous Cell Carcinoma of the Temporal Bone and External Auditory Canal: A Comparative Survival Analysis
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DOI：
10.1097/mao.0b013e3181f7ab85
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发表时间：
2010-12-01
影响因子：
2.1
通讯作者：
Antonio, Stephanie A. Moody
中科院分区：
文献类型：
--
作者：
Higgins, Thomas S.;Antonio, Stephanie A. Moody
目的：面瘫在外耳道鳞状细胞癌匹兹堡分期系统中的作用尚不清楚。资料来源：检索MEDLINE、EMBASE、Cochrane临床试验中央登记表、Cochrane、Clinicaltrials.gov和国家指南信息交换中心数据库，并辅之以手工检索。资料选择：选择最终分析的文章有关于分期和/或面神经功能、结果和随访期的个别主题数据。资料提炼：所提取的数据包括人口统计学、癌症类型和分期、存活率和面神经状况。资料综合：通过系统的文献检索确定的3046条引文21个病例系列，包括348例EAC鳞癌患者，符合分析标准。面瘫患者的总体存活率和疾病特异性存活率显著低于非面瘫患者，无论分期如何(分别为p=0.006和p=0.002)。面瘫患者的总体生存结果明显差于PITT-2000T3期癌症患者(p=0.027)，与PITT-2000T4期癌症患者无统计学差异(p=0.897)。结论：EAC鳞癌的合并数据生存分析表明，面神经受累与不良预后相关，面瘫患者的生存结果与晚期T4疾病的生存曲线更接近。根据PITT-2000系统，面瘫疾病应被归类为T4期。
Objectives: The role for facial palsy in the Pittsburgh staging system for squamous cell carcinoma (SCC) of the external auditory canal (EAC) is unclear. The objective of this study was to conduct a systematic review of published studies to determine the impact of facial palsy on survival outcomes.Data Sources: A search of MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, Cochrane, clinicaltrials.gov, and the National Guideline Clearinghouse databases was supplemented by hand searching.Study Selection: Articles selected for final analysis had individual subject data on staging and/or facial nerve function, outcome, and follow-up period.Data Extraction: Data extracted included demographics, type and stage of cancer, survival, and facial nerve status.Data Synthesis: Of 3,046 citations identified by a systematic literature search, 21 case series including 348 subjects with SCC of the EAC met criteria for analysis. The overall and disease-specific survival for subjects with facial palsy were significantly worse than subjects without facial palsy, regardless of stage (p = 0.006 and p = 0.002, respectively). The overall survival outcome for subjects with facial palsy was significantly worse than subjects with stage PITT-2000 T3-designated cancer (p = 0.027) and demonstrated no statistically significant difference from stage PITT-2000 T4-designated cancer (p = 0.897).Conclusion: This pooled-data survival analysis for SCC of the EAC demonstrates that facial nerve involvement is associated with a poor outcome and that the survival outcomes for subjects with facial palsy more closely parallel the survival curves of advanced stage T4 disease. Disease with facial palsy should be classified as stage T4, in accordance with the PITT-2000 system.