Analysis of 95 cases of squamous cell carcinoma of the external and middle ear
Analysis of 95 cases of squamous cell carcinoma of the external and middle ear
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DOI：
10.1016/j.anl.2005.11.012
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发表时间：
2006-09-01
影响因子：
1.7
通讯作者：
Omori, Koichi
中科院分区：
文献类型：
--
作者：
Yin, Min;Ishikawa, Kazuo;Omori, Koichi
目的：分析外中耳鳞状细胞癌(SCC)的临床特点、5年生存率及预后因素。回顾了来自10个机构的95例患者的年龄和性别分布、最初的主诉、分期、肿瘤位置、治疗和结果。根据匹兹堡分期系统对影响预后的因素进行讨论。结果：本病好发于50~69岁的高龄人群。男性似乎比女性更容易发病，奇怪的比率为1.7。最初的主诉不典型，12.6%的患者有复发性外耳炎或慢性中耳炎的病史。13.7%的患者发现有区域转移，但没有发现远处转移。位于外耳的鳞癌较早于中耳的鳞癌。总的5年生存率为66.8%，且随分期的延长而显著下降。I期和II期鳞癌对每种治疗策略均敏感，5年生存率为100%。III、IV期鳞状细胞癌以手术加放疗和/或化疗为主，不宜手术者以放疗和化疗为主。Ⅲ期生存率为67.2%，IV期生存率为29.5%，结合放化疗，手术切除无瘤灶可使生存率提高到72.7%。分期、手术是否完整、切缘无瘤、复发转移对生存率有显著影响。结论：局部浸润性似乎是外中耳鳞状细胞癌的主要行为。早期鳞状细胞癌易治愈，早期诊断和治疗十分重要。对于晚期肿瘤，手术切缘应保持无瘤区，手术配合放化疗可提高生存率。肿瘤分期对生存率的影响大于肿瘤部位。复发转移多发生在晚期，预后较差。(C)2005爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: To analyze the clinical characteristics, 5-year survival, and prognostic factors of squamous cell carcinoma (SCC) of the external and middle ear.Methods: A multi institutional study. Ninety five cases of patients from 10 institutions were reviewed on their age and sex distribution, initial complaints, stages, tumor locations, treatments, and outcomes. Prognostic factors were discussed based on the Pittsburgh staging system.Results: This disease seems to appear in the elderly with a peak age of 50-69 years. Males appear to be more predisposed than females with an odd ratio of 1.7. The initial complaints were not typical, while 12.6% of patients presented a history of recurrent otitis externa or chronic otitis media. Regional metastasis was recognized in 13.7% of patients, while no distant metastasis was confirmed. SCC located in the external ear could be detected in an earlier stage than that in the middle ear. The overall 5-year survival was 66.8% in total, and decreased significantly with stage. SCC in stages I and II was susceptible to each therapeutic strategy with a 5-year survival of 100%. Operation combined with radiotherapy and/or chemotherapy was the major treatment for stages III and IV SCC, while radiotherapy and chemotherapy were applied mainly for those who had been considered inappropriate for operation. The overall survival was 67.2% for stage III and 29.5% for stage IV, and operation with pathologically tumor free margin could improve the survival to 72.7% when combined with radio- and chemotherapy. Stage, completeness of operation with tumor free margin, recurrence, and metastasis have significant influence on survival.Conclusion: Local infiltration seems to be the main behavior of SCC in the external and middle ear. Early diagnosis and treatment were important because SCC in the earlier stage is susceptible to be cured. For tumors of advanced stage, operation should be performed with pathologically tumor free margin, and operation combined with radiotherapy and chemotherapy could improve the survival. Tumor stage adds more influence on survival than its location. Recurrence and metastasis mainly occur in advanced stages and result in a poor survival. (C) 2005 Elsevier Ireland Ltd. All rights reserved.