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New proposal to revise the classification for squamous cell carcinoma of the external auditory canal and middle ear

Published online by Cambridge University Press:  31 March 2021

H Shinomiya
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
N Uehara
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
T Fujita
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
K Yoshida
Affiliation:
Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
Y Imamura
Affiliation:
Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
M Teshima
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
H Kimura
Affiliation:
Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan
D Miyawaki
Affiliation:
Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
A Kakigi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
N Kiyota
Affiliation:
Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
N Otsuki
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
R Sasaki
Affiliation:
Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
E Kohmura
Affiliation:
Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan
K Nibu
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Abstract

Background

The prognosis of patients with advanced squamous cell carcinoma of the external auditory canal and middle ear has been improved by advances in skull base surgery and multidrug chemoradiotherapy during the last two decades.

Methods

Ninety-five patients with squamous cell carcinoma of the external auditory canal and middle ear who were treated between 1998 and 2017 were enrolled. The number of patients with tumour stages T1, T2, T3 and T4 was 15, 22, 24 and 34, respectively. Oncological outcomes and prognostic factors were retrospectively investigated.

Results

Among patients with T4 disease, invasion of the brain (p = 0.024), carotid artery (p = 0.049) and/or jugular vein (p = 0.040) were significant predictors of poor prognosis. The five-year overall survival rate of patients with at least one of these factors (T4b) was significantly lower than that of patients without these factors (T4a) (25.5 vs 65.5 per cent, p = 0.049).

Conclusion

It is proposed that stage T4 be subclassified into T4a and T4b according to the prognostic factors.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr H Shinomiya takes responsibility for the integrity of the content of the paper

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New proposal to revise the classification for squamous cell carcinoma of the external auditory canal and middle ear
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