A systematic review of the primary squamous cell carcinoma of the external auditory canal: survival outcome based on T-staging and proposal of a new classification

J Laryngol Otol. 2021 Feb;135(2):96-103. doi: 10.1017/S0022215121000323. Epub 2021 Feb 11.

Abstract

Objective: This study aimed to provide a systematic review on survival outcome based on Pittsburgh T-staging for patients with primary external auditory canal squamous cell carcinoma.

Method: This study was a systematic review in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines performed until January 2018; pertinent studies were screened. Quality of evidence was assessed using the grading of recommendation, assessment, development and evaluation working group system.

Results: Eight articles were chosen that reported on 437 patients with external auditory carcinoma. The 5-year overall survival rate was 53.0 per cent. The pooled proportion of survivors at 5 years for T1 tumours was 88.4 per cent and for T2 tumours was 88.6 per cent. For the combined population of T1 and T2 cancer patients, it was 84.5 per cent. For T3 and T4 tumours, it was 53.3 per cent and 26.8 per cent, respectively, whereas for T3 and T4 tumours combined, it was 40.4 per cent. Individual analysis of 61 patients with presence of cervical nodes showed a poor survival rate.

Conclusion: From this review, there was not any significant difference found in the survival outcome between T1 and T2 tumours. A practical classification incorporating nodal status that accurately stratifies patients was proposed.

Keywords: Carcinoma; Classification; Ear.

Publication types

  • Systematic Review

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / classification
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / therapy
  • Dura Mater / pathology
  • Ear Canal / pathology*
  • Ear Neoplasms / pathology
  • Facial Paralysis / epidemiology
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / secondary
  • Humans
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Neoplasm Staging / statistics & numerical data
  • Parotid Gland / pathology
  • Parotid Gland / surgery
  • Retrospective Studies
  • Survival Rate