Treatment and Prognosis of Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: A Multi-Institutional Retrospective Review of 87 Patients

Kazuhiko Ogawa, Katsumasa Nakamura, Kazuo Hatano, Takashi Uno, Nobukazu Fuwa, Jun Itami, Shizuo Kojya, Torahiko Nakashima, Akihiko Shinhama, Takashi Nakagawa, Takafumi Toita, Mitsuhiro Sakai, Takeshi Kodaira, Mikio Suzuki, Hisao Ito, Sadayuki Murayama

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77 Citations (Scopus)

Abstract

Purpose: To examine the relative roles of surgery, radiotherapy, and chemotherapy in the management of patients with squamous cell carcinomas of the external auditory canal and middle ear. Methods and Materials: The records of 87 patients with histologically confirmed squamous cell carcinoma who were treated between 1984 and 2005 were reviewed. Fifty-three patients (61%) were treated with surgery and radiotherapy (S + RT group) and the remaining 34 patients with radiotherapy alone (RT group). Chemotherapy was administered in 34 patients (39%). Results: The 5-year actuarial overall and disease-free survival (DFS) rates for all patients were 55% and 54%, respectively. On univariate analysis, T stage (Stell's classification), treatment modality, and Karnofsky performance status had significant impact on DFS. On multivariate analysis, T stage and treatment modality were significant prognostic factors. Chemotherapy did not influence DFS. The 5-year DFS rate in T1, T2, and T3 patients was 83%, 45%, and 0 in the RT group (p < 0.0001) and 75%, 75%, and 46% in the S + RT group (p = 0.13), respectively. The 5-year DFS rate in patients with negative surgical margins, those with positive margins, and those with macroscopic residual disease was 83%, 55%, and 38%, respectively (p = 0.007). Conclusions: Radical radiotherapy is the treatment of choice for early-stage (T1) diseases, whereas surgery (negative surgical margins if possible) with radiotherapy is recommended as the standard care for advanced (T2-3) disease. Further clarification on the role of chemotherapy is necessary.

Original languageEnglish
Pages (from-to)1326-1334
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume68
Issue number5
DOIs
Publication statusPublished - Aug 1 2007

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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