Contemporary Treatment Patterns in Surgically Treated Temporal Bone Cancer.

Objectives

To characterize the sociodemographic features of patients with temporal bone carcinoma and evaluate current treatment patterns.

Methods

This study analyzed data from the Cosmos database (2015-2024) to identify patients with surgically treated temporal bone malignancies using ICD-10 codes (C44.21, C44.22, and C44.29) and CPT codes for external auditory canal excision, temporal bone resection (69535), and mastoidectomy procedures. Demographic, clinical, and treatment variables, including parotidectomy, neck dissection, and perioperative therapy, were extracted. Univariable analyses were performed to assess factors associated with receipt of postoperative radiation therapy.

Results

A total of 811 patients were included. The mean age was 70.9 years, and 666 patients (82.1%) were male, non-Hispanic (726, 89.5%), and White (724, 89.3%). Squamous cell carcinoma was the most common histological subtype (63.4%). Patients most commonly resided in the South (327, 40.3%) and Midwest (235, 29.0%), with 74.1% residing in metropolitan areas. Socioeconomic status and social vulnerability index distributions were relatively even. Overall, 56.4% of patients underwent parotidectomy, neck dissection, or both. Postoperative radiation therapy was the most frequently utilized adjuvant treatment (23.1%), while immunotherapy and chemotherapy alone were rarely used. On univariable analysis, parotidectomy (OR = 1.73, 95% CI: 1.02-2.89), neck dissection (OR = 3.29, 95% CI: 1.78-5.99), and combined procedures (OR = 3.13, 95% CI: 2.13-4.65) were associated with higher odds of receiving postoperative radiation.

Conclusion

Temporal bone carcinoma primarily affects older, White male patients. Postoperative radiation therapy is the most frequently utilized adjuvant treatment and is associated with more extensive surgical management, likely reflecting greater disease extent. LEVEL OF EVIDENCE: 4