Squamous cell carcinoma of the temporal bone - Results and management
Squamous cell carcinoma of the temporal bone - Results and management
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DOI：
10.1097/mao.0b013e31816c7c71
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发表时间：
2008-06-01
影响因子：
2.1
通讯作者：
Marres, Henri
中科院分区：
文献类型：
--
作者：
Kunst, Henricus;Lavieille, Jean-Pierre;Marres, Henri
目的：评价颞骨鳞状细胞癌治疗患者的管理和生存率研究设计：回顾性分析设置：三级医疗，学术转诊中心患者：28例患者接受了颞骨鳞状细胞癌的初级治疗干预：患者采用改良匹兹堡分期系统进行分期。患者进行了局部切除术，侧颞骨切除术，或侧颞骨次全切除术，通常其次是radiotherapy.Main Outcome Measure：按肿瘤大小分组的患者的生存率进行了计算。平均随访时间为34个月（2-132个月）。Kaplan-Meier生存曲线显示，pT 1和pT 4期的5年生存率分别为83%和25%。合并生存曲线显示pT 1 p/T2和pT 3/pT 4期的5年生存率分别为85%和46%。结论：外耳道癌的长期预后主要取决于分期和早期治疗。手术可能包括侧颞骨或次全颞骨切除术;在T3和T4肿瘤中，切除术可能与腮腺浅叶切除术相结合。如果疾病是在颈部或腮腺诊断，然后颈淋巴结清扫术和全腮腺切除术也可以进行。T1、T2、T3及部分T4肿瘤切除不全者应加用放疗。T4肿瘤可以根据其基于解剖学扩展的亚分类进行治疗。
Objective: Evaluation of the management and survival of patients treated for temporal bone squamous cell carcinoma.Study Design: A retrospective analysis.Setting: Tertiary care, academic referral center.Patients: Twenty-eight patients underwent primary treatment for squamous cell carcinoma of the temporal bone.Interventions: The patients were staged using the modified Pittsburgh staging system. Patients underwent a local resection, lateral temporal bone resection, or a subtotal lateral temporal bone resection usually followed by radiotherapy.Main Outcome Measure: The survival rate of patients grouped by tumor size was calculated.Results: Staging revealed 12 pT1, 2 pT2, 4 pT3, and 10 pT4 tumors. The mean follow-up was 34 months (2-132 mo). The Kaplan-Meier survival curves showed survival rates at 5 years of 83 and 25% for the stages pT1 and pT4, respectively. The pooled survival curves showed survival rates at 5 years of 85 and 46% for the stages pT1p/T2 and pT3/pT4, respectively.Conclusion: Long-term prognosis of the carcinoma of the external auditory canal mainly depends on the stage and primary treatment. Surgery may consist of a lateral temporal bone or subtotal temporal bone resection; in T3 and T4 tumors, resection may be combined with a superficial parotidectomy. If disease is diagnosed in the neck or parotid, then a neck dissection and total parotidectomy may also be performed. Additional radiotherapy should be provided in incompletely resected T1 and all T2 and T3 tumors and part of the T4 tumors. T4 tumors may be treated according to their subclassification based on the anatomic extension.