Applicability of the Pittsburgh Staging System for Advanced Cutaneous Malignancy of the Temporal Bone
Applicability of the Pittsburgh Staging System for Advanced Cutaneous Malignancy of the Temporal Bone
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DOI：
10.1055/s-0030-1253575
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发表时间：
2010-11-01
影响因子：
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通讯作者：
Lin, James
中科院分区：
文献类型：
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作者：
Gaudet, Jacques E.;Walvekar, Rohan R.;Lin, James
目的是评估匹兹堡分期系统 (PSS)（专为原发性颞骨恶性肿瘤设计）对伴有颞骨受累的晚期耳周皮肤恶性肿瘤的适用性，并研究治疗结果和预测无复发生存的预后因素。确定了 10 名患有晚期耳周皮肤恶性肿瘤并累及颞骨的患者。患有原发性颞骨或腮腺恶性肿瘤的患者被排除在外。根据美国癌症联合委员会 (AJCC) 分期系统，所有患者的临床诊断均为 T4。根据匹兹堡分期，6 个为 T1（I 期），4 个为 T4（III 期）。平均随访时间为 13.6 个月（3 至 24 个月）。基底细胞癌患者接受广泛局部切除和外侧颞骨切除（WLE/LTBR）治疗，无需辅助治疗。三分之二 (66%) 还活着并且没有疾病；一名患者因其他原因死亡。鳞状细胞癌患者的治疗涉及多学科治疗。 Kaplan-Meier 生存曲线显示，较高阶段 PSS 肿瘤患者的疾病特异性生存预后较差。这没有达到统计显着性。与更广泛使用的 AJCC 分期系统相比，PSS 可以提供有关颞骨晚期皮肤恶性肿瘤的额外预后信息。然而，需要进一步进行更大样本量的前瞻性多中心研究来验证我们的研究结果。基底细胞癌仅使用 WLE/LTBR 即可得到良好控制，无需辅助治疗，而鳞状细胞癌则需要多模式治疗：WLE/LTBR 以及术后放疗（联合或不联合化疗）。
The objectives are to evaluate the applicability of the Pittsburgh staging system (PSS) (designed for primary temporal bone malignancies) to advanced periauricular cutaneous malignancies with temporal bone involvement and to study treatment outcomes and prognostic factors predicting recurrence-free survival. Ten patients with advanced periauricular cutaneous malignancy with temporal bone involvement were identified. Patients with primary temporal bone or parotid gland malignancies were excluded. All patients were clinically T4 at presentation by the American Joint Committee on Cancer (AJCC) staging system. Using Pittsburgh staging, six were T1 (stage I) and four were T4 (stage III). The mean follow-up was 13.6 months (3 to 24 months). Patients with basal cell carcinoma were managed with wide local excision and lateral temporal bone resection (WLE/LTBR) without adjuvant therapy. Two of three (66%) are alive and free of disease; one patient died of other causes. Treatment for squamous cell carcinoma patients involved multimodality therapy. Kaplan-Meier survival curves show a worse prognosis in terms of disease-specific survival for patients with higher-staged PSS tumors. This did not reach statistical significance. The PSS may provide additional prognostic information on advanced cutaneous malignancies of the temporal bone over the more widely used AJCC staging system. However, further prospective multicenter studies with larger sample size are required to validate our findings. Basal cell carcinoma was well controlled with WLE/LTBR alone without adjuvant therapy, whereas squamous cell carcinoma required multi-modality therapy: WLE/LTBR and postoperative radiation with or without chemotherapy.