Oya Ryohei, Takenaka Yukinori, Takemura Kazuya, Ashida Naoki, Shimizu Kotaro, Kitamura Takahiro, Yamamoto Yoshifumi, Uno Atsuhiko
Department of Otorhinolaryngology Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan.
Otol Neurotol. 2017 Oct;38(9):1333-1338. doi: 10.1097/MAO.0000000000001533.
External auditory canal squamous cell carcinoma (EACSCC) is a rare disease with no standard treatment supported by high-level evidence. The aim of this study was to investigate EACSCC prognoses according to treatment modality and thus determine the optimal intervention for early-stage disease.
PubMed, Scopus, and Ichushi-Web searches of the English and Japanese-language literature published between January 1, 2006 and December 31, 2016 were performed using the key words "external auditory canal cancer" and "temporal bone cancer."
Articles related to EACSCC that include the 5-year overall survival rate or individual patient data for histological types, follow-up periods, and final outcomes were enrolled.
Sex, age, Moody's modified Pittsburgh stage, type of treatment modality, type of operation, follow-up period, and 5-year survival rates were extracted.
Twenty articles were used for the aggregate meta-analysis using a random-effects model, and 18 articles that reported 99 patients with early-stage EACSCC were used for the individual patient data meta-analysis.
The 5-year overall survival rate of early-stage EACSCC was 77%. Postoperative radiation therapy (PORT) was performed in 45% of stage I patients and 68% of stage II patients. Survival analysis of all patients showed no differences between the surgery-only and PORT groups; however, PORT exhibited a better prognosis than surgery alone among patients with stage I disease (p = 0.003, log-rank test). This result indicated that PORT can be the standard therapy for stages I and II EACSCC.
外耳道鳞状细胞癌（EACSCC）是一种罕见疾病，尚无高级别证据支持的标准治疗方法。本研究的目的是根据治疗方式调查EACSCC的预后情况，从而确定早期疾病的最佳干预措施。
使用关键词“外耳道癌”和“颞骨癌”，对2006年1月1日至2016年12月31日期间发表的英文和日文文献进行PubMed、Scopus和Ichushi-Web检索。
纳入与EACSCC相关的文章，这些文章包括5年总生存率或组织学类型、随访期和最终结局的个体患者数据。
提取性别、年龄、穆迪改良匹兹堡分期、治疗方式类型、手术类型、随访期和5年生存率。
20篇文章用于采用随机效应模型的汇总荟萃分析，18篇报告了99例早期EACSCC患者的文章用于个体患者数据荟萃分析。
早期EACSCC的5年总生存率为77%。45%的I期患者和68%的II期患者接受了术后放疗（PORT）。对所有患者的生存分析显示，单纯手术组和PORT组之间无差异；然而，在I期疾病患者中，PORT的预后优于单纯手术（p = 0.003，对数秩检验）。这一结果表明，PORT可以作为I期和II期EACSCC的标准治疗方法。
