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J Neurol Surg B Skull Base 2013; 74(01): 054-059
DOI: 10.1055/s-0032-1331021
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Lateral Temporal Bone Resection in Advanced Cutaneous Squamous Cell Carcinoma: Report of 35 Patients

Garth F. Essig
1   Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States
,
Leon Kitipornchai
2   Department of Otolaryngology–Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Felicity Adams
2   Department of Otolaryngology–Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Dannie Zarate
3   Queensland Cancer Control Analysis Team, Brisbane, Queensland, Australia
,
Mitesh Gandhi
4   Department of Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
,
Sandro Porceddu
4   Department of Radiology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
5   School of Medicine, University of Queensland, Brisbane, Queensland, Australia
,
Benedict Panizza
2   Department of Otolaryngology–Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
5   School of Medicine, University of Queensland, Brisbane, Queensland, Australia
6   Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
› Author Affiliations
Further Information

Publication History

06 August 2012

03 October 2012

Publication Date:
12 December 2012 (online)

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Abstract

Objective To evaluate lateral temporal bone resection (LTBR) in the management of advanced cutaneous squamous cell carcinoma (SCC) with temporal bone invasion and patterns of failure.

Methods This is a retrospective study of 35 patients undergoing lateral temporal bone resection for advanced cutaneous SCC at a tertiary care center between 1995 and 2006.

Results The Pittsburgh tumor stage was T4 in 18 patients (51%), T3 in 5 (14%), T2 in 9 (26%), and T1 in 3 (9%). Clear margins were reported in 22 (63%) patients. Resection of the mandible and/or temporomandibular joint (TMJ) was required in 11 (31%) patients. Facial nerve involvement was seen in 10 (29%) patients. Survival outcomes at 2 and 5 years for overall survival were 72% and 49%; disease-free survival, 68% and 59%; and disease-specific survival, 79% and 62%, respectively. Pittsburgh T stage correlated significantly with disease-specific survival (p = 0.015) and margin status was significant for both disease-free survival (p = 0.0015) and disease-specific survival (p < 0.001).

Conclusions Surgery with curative intent is justified for cutaneous SCC invading the temporal bone with extended LTBR. Margin status was a significant predictor of outcome. Surgeons should plan preoperatively to achieve clear margins by extending the LTBR with possible nerve resection.

Keywords

temporal bone - cutaneous malignancy - squamous cell carcinoma - temporal bone resection
 

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