Survival outcomes and prognostic factors in temporal bone malignancies: A retrospective cohort of 20 patients

The present study aimed to describe the clinical features and survival of patients with temporal bone malignant tumors. A total of 20 consecutive cases treated at Beijing Tiantan Hospital (Beijing, China) between March 2014 and March 2022 were retrospectively reviewed. Of the 20 patients, 16 were men and 4 were women, with an age range of 9-90 years old. The pathological types included squamous cell carcinoma (SCC; n=7), adenoid cystic carcinoma (ACC; n=7), chondrosarcoma (n=2), fibrosarcoma (n=1), endolymphatic cystic papillary adenocarcinoma (n=1), rhabdomyosarcoma (n=1) and low-grade malignant peripheral nerve sheath tumor (n=1). Patients initially diagnosed with SCC and ACC were staged according to the revised Pittsburgh classification system (T1, n=1; T3, n=5; T4, n=8). All patients received surgery, followed by postoperative radiotherapy (RT) with/without chemotherapy in 10 patients. Kaplan-Meier analysis was used to calculate the survival rate, and the log-rank test was applied to compare the differences in survival. The duration of follow-up ranged from 1 to 140 months. Notably, the 3- and 5-year disease-specific survival (DSS) rates were 79 and 73%, and the 3- and 5-year overall survival (OS) rates were 74 and 68%. Pathological type and posterior cranial fossa meningeal involvement were significantly associated with both OS and DSS. Furthermore, patients with a positive surgical margin had a significantly worse DSS rate. In conclusion, the incidence of temporal bone malignancies is low with an insidious onset. Radical resection is the main treatment option, and postoperative RT with/without chemotherapy may be supplemented in cases of an advanced stage or when tumors have a positive surgical margin.