耳和颞骨恶性肿瘤侧颞骨切除术的治疗效果

Management outcomes following lateral temporal bone resection for ear and temporal bone malignancies

目的评估耳或颞骨恶性肿瘤侧颞骨切除术(LTBR)治疗的临床效果。方法回顾2000-2007年接受LTBR治疗的耳或颞骨恶性肿瘤患者病历。结果35例患者中,平均62.7岁,其中包括鳞状细胞癌(SCC)20例,基底细胞癌(BCC)7例,腺样囊性癌(ACC)7例,腺癌1例。5年生存率(OS)、疾病特异生存率(DSS)和无瘤生存率(DFS)分别为77%、79%和52%。完全切除能够改善OS、DSS和DFS(均P<0.004)并减少局部复发(P<0.001)。结论耳和颞骨恶性肿瘤患者中,上-前部切除包括LTBR结合术后放射的治疗有效。完全切除所有病灶能够改善生存率并减少复发。

Objective To evaluate clinical outcomes following lateral temporal bone resection（LTBR） for management of malignancies involving the ear or temporal bone. Methods A retrospective medical record review was performed on patients receiving LTBR for management of malignancies involving the ear or temporal bone between 2000 and 2007. Results In this group of 35 patients, the mean age was 62. 7 years, with tumor histopathologies including squamous cell carcinoma （ SCC, 20 ） , basal cell carcinoma （ BCC, 7 ） , adenoid cystic carcinoma（ ACC, 7 ） , and adenocarcinoma （ 1 ）. The 5-year overall survival （ OS ） , disease-specific survival （ DSS ） , and disease-free survival （DFS） were 77 % , 79 % , and 52% , respectively. Complete resection resulted in improved OS,DSS,and DFS（P 〈0. 004 for each） and reduced local recurrence（P 〈0. 001 ）. Conclusion In patients with carcinomas of the ear and temporal bone, upfront excision including LTBR is an effective management when combined with postoperative radiation therapy. Complete removal of all disease may improve survival and decrease recurrence.