Parotidectomy in the management of squamous cell carcinoma of the external auditory canal
Parotidectomy in the management of squamous cell carcinoma of the external auditory canal
复制标题
腮腺切除术治疗外耳道鳞状细胞癌
DOI：
10.1007/s00405-020-06191-5
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发表时间：
2020-07-11
影响因子：
2.6
通讯作者：
Liu, Yuehui
中科院分区：
文献类型：
--
作者：
Xie, Bingbin;Wang, Meiqun;Liu, Yuehui
目的是研究在不同肿瘤阶段的外听管（EAC）的鳞状细胞癌（SCC）管理中适当去除腮腺的最佳方法。在2003年9月至2019年4月期间，在Nanchang大学第二附属医院接受了总共39例EAC SCC患者的方法。所有患者均接受了颞骨切除术或颞下骨切除次数。在直接的腮腺浸润患者中进行了总甲状腺切除术。对腮腺淋巴结转移的患者和具有晚期阶段的患者进行了浅表核切除术，而没有腮腺受累的证据。结果平均随访期为68.7个月。五名患者发生局部复发或远处转移（12.8％）。 5年的总生存率为78.4％。在早期（T（1）和T-2）患者的5年生存率为100％，分别为III和IV的患者分别为58.9％和50.0％。仅在高级阶段患者中观察到直接的腮腺浸润，而术前和晚期患者都注意到腮腺淋巴结转移。不同肿瘤主要位置之间没有显着差异（CHI（2）= 0.1026； P = 0.749）。然而，一旦前壁渗透或侵蚀，软组织或前器官就会变得脆弱。结论腮腺管理对于实现更安全和更广泛的无肿瘤边缘很重要。对于所有高级期（T（3）和T-4）患者，应强制性甲状腺切除术。在早期阶段腮腺管理的最佳决定取决于EAC前壁的渗透或侵蚀。
PurposeTo investigate optimal approaches for appropriate removal of the parotid gland in the management of squamous cell carcinoma (SCC) of the external auditory canal (EAC) at different tumor stages.MethodsIn total, 39 patients with SCC of EAC treated at the Second Affiliated Hospital of Nanchang University between September 2003 and April 2019 were enrolled in this study. All patients underwent lateral temporal bone resection or subtotal temporal bone resection. Total parotidectomy was performed in patients with direct parotid invasion. Superficial parotidectomy was performed in patients with parotid node metastasis and patients with advanced stages without evidence of parotid involvement.ResultsThe mean follow-up period was 68.7 months. Local recurrences or distant metastases occurred in five patients (12.8%). The 5-year overall survival rate was 78.4%. The 5-year survival rate was 100% in early stage (T1and T2) patients, and 58.9 and 50.0% in patients staged III and IV, respectively. Direct parotid invasion was observed in only advanced-stage patients, while parotid node metastasis was noted in both early and advanced-stage patients preoperatively. There were no significant differences (χ2= 0.1026;p= 0.749) between different tumor primary locations. However, soft tissue or preauricular organs became vulnerable once the anterior wall was infiltrated or eroded.ConclusionParotid management is important for achieving safer and wider tumor-free margins. Total parotidectomy should be mandatory for all advanced-staged (T3and T4) patients. An optimal decision for parotid management in early stages depends on the infiltration or erosion of the anterior wall of the EAC.