新提案修订外耳道和中耳鳞状细胞癌的分类。
New proposal to revise the classification for squamous cell carcinoma of the external auditory canal and middle ear.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
J Laryngol Otol. 2021 Apr;135(4):297-303. doi: 10.1017/S002221512100089X. Epub 2021 Mar 31.
BACKGROUND
The prognosis of patients with advanced squamous cell carcinoma of the external auditory canal and middle ear has been improved by advances in skull base surgery and multidrug chemoradiotherapy during the last two decades.
METHODS
Ninety-five patients with squamous cell carcinoma of the external auditory canal and middle ear who were treated between 1998 and 2017 were enrolled. The number of patients with tumour stages T1, T2, T3 and T4 was 15, 22, 24 and 34, respectively. Oncological outcomes and prognostic factors were retrospectively investigated.
RESULTS
Among patients with T4 disease, invasion of the brain (p = 0.024), carotid artery (p = 0.049) and/or jugular vein (p = 0.040) were significant predictors of poor prognosis. The five-year overall survival rate of patients with at least one of these factors (T4b) was significantly lower than that of patients without these factors (T4a) (25.5 vs 65.5 per cent, p = 0.049).
CONCLUSION
It is proposed that stage T4 be subclassified into T4a and T4b according to the prognostic factors.
背景
在过去的二十年中，由于颅底外科和多药物放化疗的进步，晚期外耳道和中耳鳞状细胞癌患者的预后得到了改善。
方法
纳入了 1998 年至 2017 年间治疗的 95 例外耳道和中耳鳞状细胞癌患者。肿瘤分期 T1、T2、T3 和 T4 的患者人数分别为 15、22、24 和 34 例。回顾性调查了肿瘤学结果和预后因素。
结果
在 T4 疾病患者中，脑侵犯（p=0.024）、颈动脉侵犯（p=0.049）和/或颈内静脉侵犯（p=0.040）是预后不良的显著预测因素。至少有这些因素之一（T4b）的患者的五年总生存率明显低于没有这些因素的患者（T4a）（25.5%比 65.5%，p=0.049）。
结论
建议根据预后因素将 T4 分期进一步细分为 T4a 和 T4b。
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