颞骨鳞状细胞癌的生存决定因素：系统综述与荟萃分析。
Survival Determinants in Temporal Bone Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.
文献信息
| PMID | 42795919 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Martina Sebastiani |
| 作者单位 | Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy. |
| 期刊 | Journal of clinical medicine |
| SCI 分区 | Q1 |
| IF | 3.5 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景/目的： 颞骨鳞状细胞癌（TBSCC）是一种罕见且侵袭性强的恶性肿瘤，关于其预后因素的证据有限。本系统综述与荟萃分析评估了肿瘤分期、颈部淋巴结状态和手术切缘状态在TBSCC患者中的预后意义。方法：按照PRISMA 2020声明，对PubMed和Scopus从数据库建库至2025年12月29日进行了系统检索。纳入报告TBSCC患者总生存风险比（HR）的研究，这些患者根据改良Pittsburgh分类进行分期。采用随机效应模型计算合并HR。结果：共分析13项回顾性队列研究，包括801例患者。手术切缘阳性与死亡风险增加最大相关（HR，4.79，95% CI，2.35-9.75；p < 0.001），其次是颈部淋巴结转移（HR，2.81；95% CI，1.72-4.60；p < 0.001）和晚期肿瘤分期（T3-T4 vs. T1-T2；HR，2.39；95% CI，1.24-4.60；p = 0.009）。敏感性分析证实了合并估计的稳健性。结论：手术切缘阳性、晚期肿瘤分期和颈部淋巴结转移均与较差的生存显著相关，其中手术切缘阳性在三个评估因素中显示出与死亡率最大的合并关联。需要前瞻性多中心研究来验证这些发现并改善这种罕见恶性肿瘤的预后分层。
英文摘要
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.