Niemczyk Kazimierz, Karchier Emilia, Morawski Krzysztof, Bartoszewicz Robert, Arcimowicz Piotr
Katedra i Klinika Otolaryngologii Warszawskiego Uniwersytetu Medycznego.
Otolaryngol Pol. 2011 Sep;65(5 Suppl):38-45. doi: 10.1016/S0030-6657(11)70707-7.
Ear carcinoma constitutes 0.5% of all cancers of the head and neck hardly, however with poor prognosis. In the study we use University of Pittsburgh Staging System. This study is retrospective analysis of the surgical treatment outcomes of the patients with external and middle ear carcinomas in the ENT Department at the Medical University of Warsaw in years from 2004 to 2008. Histopatologicallly, there were:18 squamous cell carcinoma, 17 basal cell carcinoma, 2 neuroendocrine carcinoma, basal cell adenocarcinoma and 1 metatypical carcinoma. Tumors were localised: ear concha in 19 patients, external auditory canal in 6 patients, middle ear in 3 patients, temporal bone and skull base in 9 patients. Among 19 tumors of the auricle, basal cell carcinoma occured the most often (12 patients - 63%), following squamous cell carcinoma (6 patients - 31%), in one case (6%) metatypical carcinoma was confirmed. There were 18 tumors of external auditory canal and tumors with temporal bone involvement in stage T1-T4. In this group 8 subtotal temporal bone resection were performed, however in 5 cases tumor was not totally excised. Additional radiotherapy was performed in 5 patients, 5 died of the disease, three had recurrence in the period of the study and 8 had confirmed metastasis into the breast, lung, cervical and mediastinal lymph nodes. Generally, in this group of patients, 6 died (33%) of the disease in the period from one month to 2 years after surgery. In 6 tumors with no evidence of bone involvement resection limited to the tumor was performed. In 2 tumors of external auditory canal the resection was totally and the patients have no recurrence (100%). Squamous cell carcinoma has poor prognosis, but early diagnosis gives the chance for long-term survival.
耳癌仅占头颈部所有癌症的0.5%,然而预后较差。在本研究中,我们采用匹兹堡大学分期系统。本研究是对2004年至2008年华沙医科大学耳鼻喉科外耳道和中耳癌患者手术治疗结果的回顾性分析。组织病理学上,有:18例鳞状细胞癌、17例基底细胞癌、2例神经内分泌癌、基底细胞腺癌和1例化生型癌。肿瘤的定位情况为:19例位于耳甲,6例位于外耳道,3例位于中耳,9例位于颞骨和颅底。在19例耳廓肿瘤中,基底细胞癌最为常见(12例,占63%),其次是鳞状细胞癌(6例,占31%),1例(占6%)为化生型癌。有18例外耳道肿瘤以及累及颞骨的肿瘤处于T1 - T4期。该组中进行了8例颞骨次全切除术,但5例肿瘤未完全切除。5例患者接受了额外的放疗,5例死于该疾病,3例在研究期间复发,8例证实有转移至乳腺、肺、颈部和纵隔淋巴结。总体而言,在这组患者中,6例(33%)在术后1个月至2年期间死于该疾病。对于6例无骨受累证据的肿瘤,进行了仅限于肿瘤的切除术。在2例外耳道肿瘤中,切除完全,患者无复发(100%)。鳞状细胞癌预后较差,但早期诊断可提供长期生存的机会。