PDF herunterladen
Open Access
CC BY 4.0 · J Neurol Surg B Skull Base 2023; 84(01): 069-078
DOI: 10.1055/a-1733-2585
Original Article

Surgical Strategy for Squamous Cell Carcinoma of the External Auditory Canal: Management of Locally Advanced Cases with Skull Base Involvement

Authors

  • Seiya Goto

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Naoki Nishio 

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Kenichiro Iwami

    2   Department of Neurosurgery, Aichi Medical University, Aichi, Japan

  • Tadao Yoshida

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Takashi Maruo

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Nobuaki Mukoyama

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Hidenori Tsuzuki

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Sayaka Yokoi

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Akihisa Wada

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Mariko Hiramatsu

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Yuichiro Hayashi

    3   Graduate School of Informatics, Nagoya University, Nagoya, Japan

  • Yuzuru Kamei

    4   Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Masazumi Fujii

    5   Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan

  • Michihiko Sone

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

  • Yasushi Fujimoto

    1   Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
    6   Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Aichi, Japan
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints
Preview

Abstract

Objective Surgical indications for advanced-stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) are highly dependent on the skull base surgery team. The aim of this study was to evaluate the surgical outcomes in patients with SCC of the EAC and to clarify the surgical indication of far advanced cases using the T4 subclassification.

Methods Patients with SCC of the EAC who underwent curative treatment from 2002 to 2021 at our hospital were retrospectively reviewed. Clinical and surgical results, including operative data, overall survival (OS), and disease-specific survival (DSS), were analyzed. To clarify the surgical indication for advanced-stage tumors, we proposed the T4 subclassification.

Results In the 46 patients included in the study, 8 patients had T1 tumors, 10 had T2 tumor, 5 had T3 tumors, and 23 had T4 tumors. The 5-year DSS with T1, T2, T3, and T4 tumors were 100, 85.7, 100, and 61.7%, respectively. No prognostic impacts for margin status were found between the 5-year OS and DSS (p = 0.23 and 0.13, respectively). Patients with far-advanced-stage (T4b) tumors were significantly associated with shorter DSS than those with early-stage (T1/T2) and advanced-stage (T3/T4a) tumors (p = 0.007 and 0.03, respectively).

Conclusion The present study focused on patients with SCC of the EAC at a university hospital over a period of 20 years, especially with skull base involvement, and a T4 subclassification was proposed. Complete tumor resection in an en bloc fashion could help achieve a good survival rate even in patients with locally advanced tumors.

Keywords

external auditory canal cancer - squamous cell carcinoma - surgical strategy - overall survival - disease-specific survival - T4 subclassification

Author Contributions

S.G. and N.N. designed the study, analyzed the results, and drafted the manuscript. Data collection was performed by all the authors. M.S. and Y.F. supervised the study and assisted in preparation of the manuscript. All authors reviewed and approved the final version of the manuscript.


Supplementary Material



Publikationsverlauf

Eingereicht: 27. August 2021

Angenommen: 04. Januar 2022

Accepted Manuscript online:
07. Januar 2022

Artikel online veröffentlicht:
04. Februar 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany