Lin J C, Chen K Y, Jan J S, Wu Y P, Jame J M
Department of Radiation Oncology, Veterans General Hospital-Taichung, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1990 Apr;45(4):233-40.
Thirty-five patients with carcinoma of the auricle seen in Veterans General Hospitals, Taipei and Taichung from January 1970 to December 1988 were reviewed retrospectively. There were 28 men and 7 women. More cases occurred in the 7th and 8th decades with an average of 64 years (median 67) and ranged from 29 to 91 years. The most common manifestations at diagnosis were exophytic mass (86%) and/or ulcerative lesion (29%). Histologically, basal cell carcinoma outnumbered squamous cell carcinoma 17 to 14. The remaining 4 cases consisted of 2 melanomas, 1 sweat gland adenocarcinoma and 1 unclassified sarcoma. Eighty-eight percent (15/17) of basal cell carcinoma presented at early stage without regional lymph node or distant metastasis. They were mainly treated by surgery. One patient with multifocal lesions suffered from marginal recurrence. The 2 and 5-year survival rates were 94% and 86% respectively. Half of our 14 patients with squamous cell carcinoma had local extensive tumor but no lymph node or distant metastasis was found at the time of diagnosis. Local recurrence occurred in 4 patients, one case associated with lung metastasis. The local control rate of combined surgery and irradiation in squamous cell carcinoma was 100% (4/4), superior than that of operation alone 67% (6/9) or radiotherapy alone (0/1). The actual 2 and 5-year survival rates were 85% and 64% respectively. Our 4 patients with different pathology other than basal cell or squamous cell carcinoma had high rate of regional lymph nodes or distant metastases, presenting poor prognosis. The overall treatment failure for carcinoma of the auricle was 23% (8/35) but reduced to 14% after salvage treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
回顾性分析了1970年1月至1988年12月在台北和台中荣民总医院就诊的35例耳廓癌患者。其中男性28例,女性7例。更多病例发生在70岁和80岁,平均年龄64岁(中位数67岁),年龄范围为29至91岁。诊断时最常见的表现是外生性肿块(86%)和/或溃疡性病变(29%)。组织学上,基底细胞癌比鳞状细胞癌多,为17例对14例。其余4例包括2例黑色素瘤、1例汗腺腺癌和1例未分类肉瘤。88%(15/17)的基底细胞癌处于早期,无区域淋巴结或远处转移。主要采用手术治疗。1例多灶性病变患者出现边缘复发。2年和5年生存率分别为94%和86%。我们14例鳞状细胞癌患者中有一半局部肿瘤广泛,但诊断时未发现淋巴结或远处转移。4例患者出现局部复发,1例伴有肺转移。鳞状细胞癌联合手术和放疗的局部控制率为100%(4/4),优于单纯手术的67%(6/9)或单纯放疗(0/1)。实际2年和5年生存率分别为85%和64%。我们4例非基底细胞或鳞状细胞癌的不同病理类型患者区域淋巴结或远处转移率高,预后差。耳廓癌的总体治疗失败率为23%(8/35),但挽救治疗后降至14%。(摘要截断于250字)