Prognostic Factors in Carcinoma of the External Auditory Canal

BACKGROUND: Carcinomas of the external auditory canal are rare neoplasms (<1% of all head and neck malignant neoplasms). OBJECTIVE: To evaluate the prognostic factors in 79 patients treated in a single institution. PATIENTS AND METHODS: The disease was staged as follows: 34 patients with stage T1 to T2 tumors; 43 patients with stage T3 to T4 tumors; 2 patients with stage TX tumors; 68 patients with stage NO tumors; and 11 patients with stage N1 tumors. The initial treatment was surgery in 59 patients and radiotherapy in 9 patients. Eleven patients were not considered candidates for treatment. RESULTS: To date, 29 patients have experienced local recurrences and 2, neck metastases. The 5-year survival rates were 65% for patients who underwent surgery, 29% for patients who underwent radiotherapy, and 63% for patients who underwent a combination of surgery and radiotherapy. Univariate survival analysis showed statistical difference according to tumor type (P=.003), bone involvement (P=.002), and tumor stage (P<.001). CONCLUSION: Every effort must be undertaken to make an early diagnosis and perform radical surgical resection of squamous cell carcinomas in the external auditory canal. This study validates the staging system used for squamous cell carcinoma of the ear treated with surgery.Arch Otolaryngol Head Neck Surg. 1997;123:720-724