Arriaga M, Curtin H, Takahashi H, Hirsch B E, Kamerer D B
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania.
Ann Otol Rhinol Laryngol. 1990 Sep;99(9 Pt 1):714-21. doi: 10.1177/000348949009900909.
An accepted staging system for squamous cell carcinoma of the external auditory meatus is currently lacking and would permit accurate comparison of treatment strategies and results for patients with this unusual neoplasm. In order to develop such a staging system we reviewed the prognostic variables and the accuracy of radiographic diagnosis in 39 patients undergoing temporal bone resection for squamous carcinoma of the external auditory meatus. Predictors of poor survival were extensive tumor involvement, facial nerve paralysis, middle ear involvement, and cervical or periparotid lymphadenopathy. In a comparison of 12 specific anatomic sites, computed tomography was found to be an accurate indicator of histopathologically proven tumor invasion. On the basis of this clinical radiographic-histopathologic analysis, we propose a TNM staging system for external auditory meatus carcinoma utilizing preoperative computed tomography and physical examination. This system fulfills the requirements of the American Joint Committee on Cancer that a staging system should provide a sound basis for therapeutic planning for cancer patients by describing the survival and resultant treatment of different patient groups in comparable form.
目前缺乏一个被广泛接受的外耳道鳞状细胞癌分期系统，而这将有助于准确比较针对这种罕见肿瘤患者的治疗策略和结果。为了开发这样一个分期系统，我们回顾了39例因外耳道鳞状细胞癌接受颞骨切除术患者的预后变量和影像学诊断的准确性。生存预后差的预测因素包括肿瘤广泛累及、面神经麻痹、中耳受累以及颈部或腮腺周围淋巴结病。在对12个特定解剖部位的比较中，计算机断层扫描被发现是组织病理学证实的肿瘤侵犯的准确指标。基于这种临床影像学 - 组织病理学分析，我们提出了一种利用术前计算机断层扫描和体格检查的外耳道癌TNM分期系统。该系统符合美国癌症联合委员会的要求，即分期系统应通过以可比形式描述不同患者群体的生存情况和相应治疗，为癌症患者的治疗规划提供坚实基础。
