Evaluation of subclasses for T4-classified squamous cell carcinoma of the external auditory canal

Cindy H Nabuurs; Wietske Kievit; C René Leemans; Conrad F G M Smit; Michiel W M van den Brekel; Robert J Pauw; Bernard F A M van der Laan; Jeroen C Jansen; Martin Lacko; Weibel W Braunius; Chunfu Dai; Xunbei Shi; Giovanni Danesi; Jan Bouček; Robert P Takes; Henricus P M Kunst

doi:10.1002/hed.27082

Evaluation of subclasses for T4-classified squamous cell carcinoma of the external auditory canal

Head Neck. 2022 Aug;44(8):1787-1798. doi: 10.1002/hed.27082. Epub 2022 May 13.

Authors

Cindy H Nabuurs^{1

2}, Wietske Kievit^{1

2

3}, C René Leemans⁴, Conrad F G M Smit⁴, Michiel W M van den Brekel⁵, Robert J Pauw⁶, Bernard F A M van der Laan^{7

8}, Jeroen C Jansen⁹, Martin Lacko¹⁰, Weibel W Braunius¹¹, Chunfu Dai¹², Xunbei Shi¹², Giovanni Danesi¹³, Jan Bouček¹⁴, Robert P Takes^{1

2}, Henricus P M Kunst^{1

2

10}

Affiliations

¹ Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.
² Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
³ Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
⁴ Department of Otolaryngology and Head and Neck Surgery, Amsterdam University Medical Centers, VU University, Amsterdam, the Netherlands.
⁵ Department of Head and Neck Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
⁶ Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
⁷ Department of Otorhinolaryngology and Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
⁸ Department of Otorhinolaryngology and Head and Neck Surgery, Haaglanden Medical Center, The Hage, the Netherlands.
⁹ Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
¹⁰ Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Maastricht University Medical Center, Maastricht, the Netherlands.
¹¹ Department of Head and Neck Surgical Oncology, University Medical Center/Utrecht Cancer Center, Utrecht, the Netherlands.
¹² Department of Otology & Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China.
¹³ Department of Otorhinolaryngology and Skull Base Microsurgery-Neurosciences, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy.
¹⁴ Department of Otorhinolaryngology and Head and Neck Surgery, The First Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic.

Abstract

Background: T4-classified squamous cell carcinoma (SCC) of external auditory canal (EAC) can potentially involve different anatomical structures, which could translate into different treatment strategies and survival outcomes within one classification. Our aim is to evaluate the clinical added value of T4-subclasses proposed by Lavieille and by Zanoletti.

Methods: Retrospective data, including patients with primary operated cT4-classified EAC SCC, was obtained from 12 international hospitals. We subclassified according to the T4-subclasses. The treatment strategies, disease-free survival (DFS) and overall survival per subclass were calculated.

Results: A total of 130 T4-classified EAC SCC were included. We found commonly used treatment strategies per subclass according to Lavieille and the DFS seems also to differ per subclass. Subclass according to Zanoletti showed comparable treatment strategies and survival outcomes per subclass.

Conclusion: Our study suggests that the subclass according Lavieille might have added value in clinical practice to improve care of T4-classified EAC SCC.

Keywords: disease-free survival; neoplasm staging; squamous cell carcinoma; temporal bone; treatment.

MeSH terms

Carcinoma, Squamous Cell* / pathology
Ear Canal / pathology
Ear Neoplasms* / pathology
Humans
Neoplasm Staging
Retrospective Studies
Treatment Outcome