Apthorp Eleanor, Lam Rebecca, Obholzer Rupert, Jeannon Jean-Pierre, Oakley Richard, Rovira Aleix
GKT School of Medical Education, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK.
Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
Eur Arch Otorhinolaryngol. 2025 Feb 20. doi: 10.1007/s00405-025-09274-3.
External auditory canal (EAC) skin cancer is often diagnosed at advanced stages, leading to poor survival outcomes. Our study aims to describe disease characteristics, treatments and outcomes of patients with EAC cancer, increasing understanding of the management of this rare disease.
Retrospective, observational study including patients with non-melanoma EAC skin cancer treated at Guy's and St Thomas' Head and Neck Unit from 2012 to 2021, with follow-up until October 2023. Patient with EAC or auricular primaries extending into the EAC were included. Demographic, histopathological, and surgical data were obtained from electronic records.
Thirty-eight patients were included, 86.8% treated with curative intent. The median follow-up was 49.9 months. One, three, and five-year overall survival for patients treated curatively were 100%, 96.9% and 75.3%, respectively, versus 40.0%, 0.0% and 0.0% for palliative. 68.4% had advanced disease (Pittsburgh staging, III: 18.4%, IV: 50.0%). 39.5% were treated after recurrent or persistent disease. Histological subtypes included squamous cell carcinoma (60.5%), basal cell carcinoma (26.3%) and others (13.2%). Among those treated surgically (n = 31), 74.2% underwent lateral temporal bone resection and 29.0% wide local excision. 83.9% had parotidectomy, neck dissection or both. 51.6% received post-operative radiotherapy/chemoradiotherapy. Advanced stage was significantly associated with reduced overall survival (p = 0.05) but not disease-free survival (p = 0.25). No primary site features, regional metastasis (p = 0.63), direct parotid invasion (p = 0.71) or age (p = 0.15) significantly impacted survival.
According to the good outcomes reported, this study suggests lowering the threshold for radical treatment may improve outcomes for patients with potentially poor prognostic features.
外耳道（EAC）皮肤癌常于晚期被诊断出来，导致生存结局较差。我们的研究旨在描述EAC癌患者的疾病特征、治疗方法及预后，以增进对这种罕见疾病管理的了解。
一项回顾性观察研究，纳入2012年至2021年在盖伊和圣托马斯头颈科接受治疗的非黑色素瘤EAC皮肤癌患者，随访至2023年10月。纳入EAC或耳部原发灶扩展至EAC的患者。从电子记录中获取人口统计学、组织病理学和手术数据。
共纳入38例患者，86.8%接受了根治性治疗。中位随访时间为49.9个月。接受根治性治疗患者的1年、3年和5年总生存率分别为100%、96.9%和75.3%，而姑息治疗患者分别为40.0%、0.0%和0.0%。68.4%患有晚期疾病（匹兹堡分期，III期：18.4%，IV期：50.0%）。39.5%在疾病复发或持续后接受治疗。组织学亚型包括鳞状细胞癌（60.5%）、基底细胞癌（26.3%）和其他（13.2%）。在接受手术治疗的患者（n = 31）中，74.2%接受了颞骨外侧切除术，29.0%接受了广泛局部切除术。83.9%进行了腮腺切除术、颈部淋巴结清扫术或两者皆有。51.6%接受了术后放疗/放化疗。晚期与总生存率降低显著相关（p = 0.05），但与无病生存率无关（p = 0.25）。无原发部位特征、区域转移（p = 0.63）、腮腺直接侵犯（p = 0.71）或年龄（p = 0.15）对生存率有显著影响。
根据所报告的良好预后，本研究表明降低根治性治疗的阈值可能改善具有潜在不良预后特征患者的预后。
