Cancer of the external auditory canal

Abstract

Objective: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma.

Design: Retrospective case series of all patients who had surgery between 1979 and 2000. Median follow-up was 47 months (range, 2-148 months). Data on age, sex, symptoms, TNM status, histopathological diagnosis, surgery, adjunctive therapy, sequelae, recurrence, and status at follow-up were obtained.

Setting: An ear, nose, and throat department in an ambulatory and hospitalized care center.

Patients: Ten women and 10 men with previously untreated primary cancer. Median age at diagnosis was 67 years (range, 31-87 years). Survival data included 18 patients with at least 2 years of follow-up or recurrence.

Intervention: Local canal resection or partial temporal bone resection.

Main outcome measure: Recurrence rate.

Results: Half of the patients had squamous cell carcinoma. Thirteen of the patients had stage I tumor (65%), 2 had stage II (10%), 2 had stage III (10%), and 3 had stage IV tumor (15%). Twelve patients were cured. All patients with stage I or II cancers were cured except 1 with adenoid cystic carcinoma. No patients with stage III or IV cancer were cured. All recurrences developed in patients with incompletely resected tumors.

Conclusions: The outcome was related to the stage of disease, suggesting that the Pittsburgh staging system is useful also in patients with non-squamous cell carcinoma. Patients with early cancer benefited from a less aggressive surgical approach, while survival was poor in patients with advanced cancer with incompletely resected tumors despite adjuvant radiotherapy.