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Prevalence of occult nodal metastases in squamous cell carcinoma of the temporal bone: A systematic review and meta-analysis
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  • Daniele Borsetto,
  • Ananth Vijendren,
  • Gianni Franchin,
  • Neil Donnelly,
  • Patrick Axon,
  • Liam Masterson,
  • Manohar Bance,
  • Athanasios Saratziotis,
  • Jerry Polesel,
  • Paolo Boscolo-Rizzo,
  • James Tysome
Daniele Borsetto
Addenbrooke's Hospital

Corresponding Author:[email protected]

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Ananth Vijendren
Colchester Hospital University NHS Foundation Trust
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Gianni Franchin
Aviano AB, Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Pordenone, Friuli Venezia Giulia, IT
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Neil Donnelly
Cambridge University Hospital NHS Foundation Trust
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Patrick Axon
Cambridge University Hospitals
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Liam Masterson
Addenbrookes Hospital
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Manohar Bance
Addenbrooke's Hospital
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Athanasios Saratziotis
University Hospital of Larissa
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Jerry Polesel
Aviano AB
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Paolo Boscolo-Rizzo
University of Padua
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James Tysome
Cambridge University Hospitals
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Objectives : Primary : To determine the rate of occult cervical metastasis in primary temporal bone squamous cell carcinomas (TBSSC). Secondary : to perform a subgroup meta-analysis of the risk of occult metastasis based on the clinical stage of the tumour and its risk based on corresponding levels of the neck Design : A systematic review and meta-analysis of papers searched through Medline, Cochrane, Embase, Scopus and Web of Science up to January 2021 to determine the pooled rate of occult lymph node/parotid metastases. Quality assessment of the included studies was assessed through the Newcastle-Ottawa scale. Setting : Centres around the world that perform surgery for TBSCC Participants : Patients with TBSCC Results : Overall, 9 out of 1034 screened studies met the inclusion criteria, for a total of 907 patients of which 388 had TBSCC. Out of the 191 patients who underwent a neck dissection, 21 had positive lymph nodes giving a pooled rate of occult metastases of 11% (95% CI: 7%-17%). When analysed using the Modified Pittsburg staging system, 21 pT2 cases had a pooled occult metastases rate of 3% (95% CI: 0%-21%), 27 pT3 cases had a pooled occult metastases rate of 12% (95% CI: 1%-60%), and 65 pT4 cases had a pooled occult metastases rate of 14% (95% CI: 7%-25%). Data available showed that most of the positive nodes were in Level II. Conclusion: The rate of occult cervical metastases in TBSCC increases based on the tumour (T) staging of the disease with majority of nodal disease found in level 2 of the neck.