2025 Poster Presentations
P096: TEMPORAL BONE RESECTION FOR NON-MELANOMA SKIN CANCER: PREDICTIVE FACTORS OF RECURRENCE AND SURVIVAL
Douglas P Cavalcanti, MD; Terence P de Farias, PhD; Thais B de Paula, MD; Izabella C Santos, PhD; Bernardo C Peryassú, Msc; Bruno A Sousa, MSc; Fernando L Dias, PhD; Brazilian National Cancer Institute
The purpose of this study was to define predictive factors of recurrence and survival in patients who underwent temporal bone resection for head and neck non melanoma skin cancer at Brazilian National Cancer Institute.
Methods: It was made a retrospective study of 30 patients submitted to temporal bone resection for head and neck non melanoma skin cancer to identify factors related to recurrence and survival and
Results: The epithelial histologies included squamous cell carcinoma – SCC: n=11 (36.7%) and basal cell carcinoma - BCC: n=19 (63.3%). Cervical metastases were found in 3 patients (10%), with 11 submitted to neck dissection. Overall survival in 5 years was 54.6%, recurrence free survival in 5 years was 55%, specific disease survival was 52.4%. The site of origin of the tumor distribution by skin region was classified between periauricular skin n=13 (43,3%), auricula n=9 (30%), external auditory canal n=3 (10%), the remaining cases being combinations of these sites at presentation. It was performed lateral temporal bone ressection according to the Medina classification: type 1: n=6 (20%),type 2 n=4 (13.3%), type 3 n=3(10%), type 4 n=10 (33.3%), subtotal n=4 (13.3%) and total n=1 (3.3%). In relation to margins n=22 cases(73.6%) had free margins and n=6 cases (20%) had positive margins, with two cases (6.4%) with no information about pathologic margins. In relation to treatment n=15 cases (30%) recieved parotidectomy, n=13 cases ( 43.3%) recieved mandibulectomy, n =11 cases (36.7%) had neck dissection, n=12 cases (40%) had facial nerve sacrifice. Bone and perineural invasion was identified in n=12 cases (40%), whereas vascular and lymphatic invasion was present in n=1 case (3.3%). Of the patients which presented recurrence, 72.7% were T3 and T4 tumors. It was identified increased risk for recurrence in patients with 4 or more of the following factors: male sex, alcohol abuse, periauricular skin site of origin, SCC histology, N+, perineural invasion, facial nerve sacrifice e adjuvant therapy.
Conclusion: The factors which most related with recurrence and survival were: male sex, alcohol abuse, periauricular skin site of origin, SCC histology, N+, perineural invasion, facial nerve sacrifice e adjuvant therapy., suggesting a possible application of these factors in a predictive score.