Skull Base 2011; 21(6): 389-396
DOI: 10.1055/s-0031-1287682
ORIGINAL ARTICLE

© Thieme Medical Publishers

Outcomes of Temporal Bone Resection for Locally Advanced Parotid Cancer

Saral Mehra1 , 2 , 3 , Luc G. Morris3 , Jatin Shah3 , Mark Bilsky4 , Samuel Selesnick1 , 4 , Dennis H. Kraus3
  • 1Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medical College, New York, New York
  • 2Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York
  • 3Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
  • 4Department of Neurosurgery, Sloan-Kettering Cancer Center, New York, New York
Further Information

Publication History

Publication Date:
14 September 2011 (eFirst)

ABSTRACT

This study was conducted to report outcomes and identify factors predictive of survival and recurrence in patients undergoing lateral temporal bone resection (LTBR) as part of an extended radical parotidectomy for parotid cancer. This is a retrospective cohort study which includes all patients undergoing LTBR for parotid cancer between 1994 and 2010 at two affiliated academic centers. Survival and recurrence rates were analyzed using the Kaplan-Meier method and Cox multivariate regression. A total of 12 patients with median follow-up duration of 30.6 months were included: 6 de novo cases and 6 patients referred after local recurrence. Actuarial locoregional control at 2 years was 73%. Most patients (11; 92%) developed disease recurrence with distant metastases the most common site of first failure (83%). Overall and disease-specific survival rates were 80% at 2 years and 22.5% at 5 years. Recurrence-free survival (RFS) was 67% at 2 years and 8.3% at 5 years. On multivariate analysis, surgical margin status was an independent predictor of RFS (hazard ratio = 3.85, p = 0.045). In advanced parotid cancer, LTBR with a goal of gross total resection offers good locoregional control with an acceptable complication rate. The benefits of this surgery must be balanced with the morbidity and low likelihood of long-term survival, with most patients ultimately experiencing disease recurrence and death.