Squamous cell carcinoma of the temporal bone: clinical outcomes from radical surgery and postoperative radiotherapy.

OBJECTIVE: To review the treatment of squamous carcinoma of the temporal bone at a regional skull base unit for the period 1982-2012. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Sixty patients with primary squamous carcinoma of the temporal bone. INTERVENTIONS: Multidisciplinary team approach including surgical resection, reconstruction, and postoperative radiotherapy. MAIN OUTCOME MEASURES: Disease-specific survival, overall survival. RESULTS: The 5-year disease-specific survival for the whole cohort was 44% (CI, 37%-51%). Multivariable analysis revealed nodal status, poorly differentiated squamous cell histology, and carotid involvement to be poor prognostic indicators. CONCLUSION: Although the survival figures in this series are comparable with the best outcomes from other units, our experience would suggest improvements can still be achieved by reconsidering the selection of patients for neck dissection and temperomandibular joint excision in early stage disease. We also conclude that postoperative radiotherapy should be delivered to all patients, including surgical salvage cases who may have received previous irradiation. Finally, the minority of patients with poor prognostic features should be offered a more palliative therapeutic approach.