Survival Determinants in Temporal Bone Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis
In brief
Positive margins mark nearly fivefold higher mortality in temporal bone cancer
A meta-analysis of 13 retrospective studies involving 801 patients found that positive surgical margins were associated with nearly five times the mortality hazard, the strongest association among the factors studied. Cancer in neck nodes and advanced tumor stage were also linked to poorer survival, but prospective studies are needed to confirm these findings in this rare cancer.
- Journal
- Journal of clinical medicine (Q1)
- Published
- 15 September 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Martina Sebastiani, Alessandro Facheris, Daniele Bernardeschi, Luca Canali, Giovanni Colombo, Matteo Di Bari
- PMID
- 42795919
- DOI
- 10.3390/jcm15187143
Why clinicians should know about it
- Picked for Surgical Oncology (paper of the day, 30 September 2026): Positive margins, nodal status, stage affect survival
Abstract
Background/Objectives: Temporal bone squamous cell carcinoma (TBSCC) is a rare and aggressive malignancy with limited evidence regarding prognostic factors. This systematic review and meta-analysis evaluated the prognostic significance of tumor stage, cervical nodal status, and surgical margin status in patients with TBSCC. Methods: A systematic search of PubMed and Scopus was conducted from database inception to December 29, 2025, in accordance with the PRISMA 2020 statement. Studies reporting hazard ratios (HRs) for overall survival in patients with TBSCC staged according to the modified Pittsburgh classification were included. Pooled HRs were calculated using random-effects models. Results: Thirteen retrospective cohort studies including 801 patients were analyzed. Positive surgical margins were associated with the greatest increase in mortality risk (HR, 4.79, 95% CI, 2.35-9.75; p < 0.001), followed by cervical nodal metastasis (HR, 2.81; 95% CI, 1.72-4.60; p < 0.001) and advanced tumor stage (T3-T4 vs. T1-T2; HR, 2.39; 95% CI, 1.24-4.60; p = 0.009). Sensitivity analyses confirmed the robustness of the pooled estimates. Conclusions: Positive surgical margins, advanced tumor stage, and cervical nodal metastasis were all significantly associated with poorer survival, with positive surgical margins showing the largest pooled association with mortality among the three evaluated factors. Prospective multicenter studies are needed to validate these findings and improve prognostic stratification in this rare malignancy.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.