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.
