Park Jung Mee, Kong Ji Sun, Chang Ki Hong, Jun Beom Cho, Jeon Eun Ju, Park So Young, Park Shi Nae, Park Kyoung Ho
Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Int Adv Otol. 2018 Aug;14(2):278-284. doi: 10.5152/iao.2018.4952.
To analyze the clinical characteristics and evaluate the surgical outcomes of carcinoma of the external auditory canal (CEAC).
Overall, 31 patients from four multicenter hospitals, who were diagnosed and surgically treated for CEAC in 2009-2014, were enrolled for this retrospective study. Medical records were reviewed to determine cancer stage according to the Pittsburgh classification. Clinical data of age, sex, site, initial symptoms, surgery extent, postoperative complications including recurrence, follow-up period, and current patient status were collected for analysis. Five-year cumulative survival rate was obtained using Kaplan-Meier method.
At initial diagnosis, 22 patients were in the early stages (stage I: 15; stage II: 7) and 9 patients were in the advanced stages (stage III: 1; stage IV: 8). Lymph node metastasis was present in 5 patients and distant metastasis in 2. Of the 31 patients, 4 patients died (stage II: 1, stage IV: 3) during the follow-up period. Early-stage patients showed 100% 5-year estimated cumulative survival rate, whereas the advanced-stage patients showed 5-year estimated survival rate of 53.6% (p=.006). The overall survival rate of all enrolled patients was 90.3%. Although 5-year estimated disease-free survival rate of stage I was 100.0%, that for stage II was low at 30.0% because of considerable recurrences.
The results of this multicenter study suggest that more aggressive treatment modality, including adjuvant therapy, is necessary for patients with CEAC with Pittsburgh stage II or more.
分析外耳道癌(CEAC)的临床特征并评估手术疗效。
本回顾性研究纳入了2009年至2014年期间在四家多中心医院被诊断并接受手术治疗的31例CEAC患者。查阅病历,根据匹兹堡分类确定癌症分期。收集患者的年龄、性别、病变部位、初始症状、手术范围、术后并发症(包括复发)、随访时间及当前患者状态等临床资料进行分析。采用Kaplan-Meier法计算5年累积生存率。
初诊时,22例患者处于早期(I期:15例;II期:7例),9例患者处于晚期(III期:1例;IV期:8例)。5例患者出现淋巴结转移,2例出现远处转移。31例患者中,4例(II期:1例,IV期:3例)在随访期间死亡。早期患者的5年估计累积生存率为100%,而晚期患者的5年估计生存率为53.6%(p = 0.006)。所有入组患者的总生存率为90.3%。尽管I期患者的5年估计无病生存率为100.0%,但由于复发率较高,II期患者的该生存率较低,仅为30.0%。
这项多中心研究结果表明,对于匹兹堡II期及以上的CEAC患者,需要采取更积极的治疗方式,包括辅助治疗。