Temporal Bone Squamous Cell Carcinoma: Diagnostic Delays and Impact on Survival

Introduction:
Temporal bone squamous cell carcinoma (TBSCC) is a rare, aggressive
malignancy frequently associated with poor prognosis due to its
typically late diagnosis.
Objective:
This study aimed to analyze diagnostic delays in TBSCC patients,
assessing their impact on tumor staging and survival to improve clinical
management and healthcare systems.
Methods:
This retrospective study was conducted at Rajshahi Medical College,
Rajshahi, Bangladesh, from June 2020 to July 2021on 150 patients
diagnosed with TBSCC. Patients’ records were reviewed for
demographic information, clinical history, diagnostic timelines, tumor
staging, treatment methods, and survival outcomes. They measured
diagnostic delays in three intervals: from symptom onset to the first
medical visit, from the first visit to the histological diagnosis, and the
overall delay. Survival data were gathered over a 3-year follow-up
period. The statistical analysis was conducted on SPSS v26.0, including
descriptive statistics, chi-square tests, and Kaplan-Meier survival
analysis.
Results:
Most of the study participants were male (64%) with an average age of
58.3 years. Patients mostly lived in rural areas (61.3%) and had
significant smoking histories (54.7%). There were notable diagnostic
delays, with 30.7% of patients experiencing total delays of more than six
months. Advanced-stage disease (Stage III-IV) was found in 66.7% of the
patients. The three-year survival rate was 56.0%. Survival was strongly
linked to tumor stage (Stage I: 88.9% vs Stage IV: 25.0%, p=0.007) and
diagnostic delay (≤3 months: 77.5% vs >6 months: 32.6%, p=0.004).
Conclusion:
Delays in diagnosis significantly affect survival in TBSCC. Late diagnosis
often results in advanced-stage cancer and lower survival rates. Early
detection strategies and better access to healthcare are essential for
improving outcomes in this aggressive disease.