Development and validation of a nomogram to predict overall survival in patients with External auditory canal cancer

We aimed to examine the influence of various prognostic factors on the outcome of external auditory canal (EAC) cancer and create a graphical prediction tool, marking a first in this field, premised on these determinants.

We retrospectively analysed 173 patients with EAC cancer, making this the largest patient cohort in the literature. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used to assess the differences between established prognostic variables. The risk factors for overall survival (OS) rates were analysed by univariate and multivariable Cox regression analyses.

The cohort demonstrated 2-, 5-, and 10-year progression-free survival (PFS) rates of 86.9%, 72.7%, and 60.1%, respectively. The overall survival (OS) rates for the cohort at 2, 5, and 10-years were 93.6%, 80.6%, and 65.8%, respectively. The key predictors of both OS and PFS were squamous cell carcinoma, T stage, margin status, and radiotherapy. The nomogram showed good predictive accuracy and discriminative ability. Post-radiotherapy follow-up data indicated that the incidence rates of allotriogeustia, saprodontia, xerostomia, difficulty in opening the mouth, and facioplegia were 1.3%, 6.5%, 22.7%, 8.4%, and 3.2%, respectively.

Our findings highlight the significance of squamous cell carcinoma, T stage, margin status, and radiotherapy as predictors of OS and PFS. Validation analysis confirmed the applicability of the developed nomogram in predicting individual survival probabilities for patients with EAC cancers, signifying a notable progression in the diagnosis and treatment of EAC cancers.