Sites of invasion of cancer of the external auditory canal predicting oncologic outcomes

Kiyoto Shiga; Ken-Ichi Nibu; Yasushi Fujimoto; Takahiro Asakage; Akihiro Homma; Hiroki Mitani; Takenori Ogawa; Kenji Okami; Shigeyuki Murono; Shigeru Hirano; Tsutomu Ueda; Nobuhiro Hanai; Kiyoaki Tsukahara; Ichiro Ota; Seiichi Yoshimoto; Takeshi Shinozaki; Shigemichi Iwae; Katsunori Katagiri; Daisuke Saito; Naomi Kiyota; Makoto Tahara; Fumiaki Takahashi; Ryuichi Hayashi

doi:10.1002/hed.26800

Sites of invasion of cancer of the external auditory canal predicting oncologic outcomes

Head Neck. 2021 Oct;43(10):3097-3105. doi: 10.1002/hed.26800. Epub 2021 Jul 9.

Authors

Kiyoto Shiga¹, Ken-Ichi Nibu², Yasushi Fujimoto³, Takahiro Asakage⁴, Akihiro Homma⁵, Hiroki Mitani⁶, Takenori Ogawa⁷, Kenji Okami⁸, Shigeyuki Murono⁹, Shigeru Hirano¹⁰, Tsutomu Ueda¹¹, Nobuhiro Hanai¹², Kiyoaki Tsukahara¹³, Ichiro Ota¹⁴, Seiichi Yoshimoto¹⁵, Takeshi Shinozaki¹⁶, Shigemichi Iwae¹⁷, Katsunori Katagiri¹, Daisuke Saito¹, Naomi Kiyota¹⁸, Makoto Tahara¹⁹, Fumiaki Takahashi²⁰, Ryuichi Hayashi¹⁶

Affiliations

¹ Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Yahaba, Japan.
² Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
³ Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
⁴ Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
⁵ Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
⁶ Department of Head and Neck Surgery, Cancer Institute Hospital of JFCR, Tokyo, Japan.
⁷ Department of Otolaryngology - Head and Neck Surgery, Tohoku University Hospital, Sendai, Japan.
⁸ Department of Otolaryngology, Tokai University School of Medicine, Isehara, Japan.
⁹ Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.
¹⁰ Department of Otolaryngology - Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
¹¹ Department of Otorhinolaryngology - Head and Neck Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
¹² Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
¹³ Department of Otorhinolaryngology - Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
¹⁴ Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Kashihara, Japan.
¹⁵ Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan.
¹⁶ Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
¹⁷ Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan.
¹⁸ Department of Medical Oncology/Hematology, Kobe University Hospital Cancer Center, Kobe, Japan.
¹⁹ Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
²⁰ Division of Medical Engineering, Department of Information Science, Iwate Medical University, Yahaba, Japan.

PMID: 34240528
DOI: 10.1002/hed.26800

Abstract

Background: This study aimed to reveal the influence of the invasion site of external auditory canal (EAC) cancer by analyzing the outcome of patients with advanced tumor.

Methods: A total of 111 patients with T4 EAC cancer were enrolled in this study. Of these patients, 79 underwent chemoradiotherapy and 32 underwent surgery under curative intent. Univariate and multivariate analyses and the Kaplan-Meier method were used to focus on the tumor invasion sites and overall survival of the patients.

Results: The 3-year overall survival rate of all patients was 55.0%. In multivariate analysis, the only significant invasion site for overall survival was the facial nerve, with the dura mater being the next most influential site. When Kaplan-Meier survival curve was calculated, facial nerve and dura mater were the significant factors resulting in poor patient outcomes.

Conclusion: The facial nerve and dura mater are crucial sites of EAC cancer for patient outcomes.

Keywords: external auditory canal; invasion; multi-institutional study; outcome; squamous cell carcinoma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Squamous Cell* / pathology
Ear Canal / pathology
Ear Neoplasms* / pathology
Ear Neoplasms* / surgery
Humans
Neoplasm Staging
Retrospective Studies
Treatment Outcome