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Primary squamous cell carcinoma of the external auditory canal - a nationwide study
K Sandström1, S Olaison2, M Werner3
1Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Background:
National studies on primary malignant tumours arising from the external auditory canal (EAC) are rare.
Objectives:
To investigate the incidence and outcomes of squamous cell carcinoma of the external auditory canal (SCC-EAC) in Sweden.
Materials And Methods:
The retrospective study included patients diagnosed with SCC-EAC in Sweden from 2007 to 2017.
Results:
Forty-six patients with SCC-EAC were identified. The crude annual incidence was 0.043 per 100,000 inhabitants (age-standardised rate (ASR): 0.024 WHO, 0.045 Europe). Among the 40 patients treated with curative intent, 85% achieved remission, and 23% subsequently relapsed. Uncertain or non-radical primary surgery significantly correlated with residual tumour or relapse (p = 0.01) and disease-specific mortality (p = 0.002). Clear margins were achieved in 60% of T1 tumours and 21% of T4 tumours, indicating surgical undertreatment. None of the patients who underwent radical surgery died of SCC-EAC.
Conclusions And Significance:
The incidence of SCC-EAC in Sweden was lower than international rates. Non-radical surgery drastically increased mortality, and postoperative radiotherapy (PORT) could not fully compensate for incomplete resection. Consequently, a more aggressive surgical approach is justified.
