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Yamada A, Shinomiya H, Uehara N, Iritani K, Tatehara S, Furukawa T, Teshima M, Miyawaki D, Fujita T, Kakigi A, Kiyota N, Sasaki R, Nibu KI. Oncological outcomes of concurrent chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil for locally advanced squamous cell carcinoma of the external auditory canal: A single-center study. Head Neck 2023; 45:2498-2504. [PMID: 37503962 DOI: 10.1002/hed.27461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/30/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma of the external auditory canal (EACSCC) is a rare condition. However, a standard treatment has not yet been established. We retrospectively evaluated the efficacy, adverse events, and feasibility of TPF-CCRT (concomitant chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil) in patients with advanced EACSCC. METHODS Thirty-five consecutive patients with advanced EACSCC (T3, T4) initially treated with TPF-CCRT at Kobe University Hospital were included. T4 diseases with invasion of the brain, internal carotid artery, or internal jugular vein were classified as T4b, and those without these features were classified as T4a. RESULTS Five-year overall survival rates for T3 and T4 were 100% and 64.2%, respectively. A significant difference was observed between T4a and T4b (82.4% vs. 30%, p = 0.007). Five-year progression-free survival rates of T3, T4a, and T4b were 100%, 68%, and 20% (p = 0.022), respectively. CONCLUSIONS TPF-CCRT should be considered as a plausible treatment option for advanced EACSCC.
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Affiliation(s)
- Akihiro Yamada
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Natsumi Uehara
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keisuke Iritani
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Tatehara
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Miyawaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Fujita
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akinobu Kakigi
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Kobe University Hospital Cancer Center, Kobe, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Jang IJH, Thong JF, Teo CEH, Sommat K. Analysis of Prognostic Factors For External Auditory Canal Carcinoma: A 22-Year Experience. Laryngoscope 2023; 133:2203-2210. [PMID: 36478582 DOI: 10.1002/lary.30504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/07/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to investigate the prognostic factors and treatment outcomes in patients with the external auditory canal (EAC) squamous cell carcinoma (SCC). METHODS All patients diagnosed with EAC SCC and treated with curative intent at a single tertiary institution were retrospectively reviewed over a 22-year period. Treatment modalities included surgery with adjuvant treatment or definitive radiotherapy. The primary endpoints were overall survival (OS) and disease-specific survival (DSS). RESULTS There were 51 patients in our cohort. The 5-year OS and DSS were 64.0% ± 7.0% and 72.0% ± 7.0% respectively. Patients in the surgical arm and RT arm showed no significant difference in OS, DSS, and LRFS (p = 0.075, 0.062, 0.058 respectively). Compared to other routes of spread within the temporal bone, pattern of posterior disease invasion (involving mastoid/sigmoid sinus) showed poorer OS and DSS on multivariate analysis (hazard ratio, HR4.34 and 5.88; p = 0.006 and 0.009). On multivariate analysis, the following factors were independently prognostic of poorer OS and DSS: Previous radiotherapy (HR 3.29 and 4.81, p = 0.021 and p = 0.029); Presence of facial nerve palsy (HR 3.80 and 7.63, p = 0.013 and p = 0.003); Posterior pattern of invasion (HR4.05 and 3.59, p = 0.013 and p = 0.043). Advanced modified Pittsburgh stage was not predictive of poor OS and DSS (HR1.17 and 1.17 E+5, p = 0.786 and p = 0.961). CONCLUSION Presence of previous radiotherapy, facial nerve palsy and posterior pattern of disease invasion were independent prognostic factors of poorer survival in patients with EAC SCC. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2203-2210, 2023.
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Affiliation(s)
- Isabelle J H Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Jiun Fong Thong
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Constance E H Teo
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Kiattisa Sommat
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
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3
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Komune N, Kuga R, Hongo T, Kuga D, Sato K, Nakagawa T. Impact of Positive-Margin Resection of External Auditory Canal Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:4289. [PMID: 37686564 PMCID: PMC10486369 DOI: 10.3390/cancers15174289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Positive-margin resection of external auditory canal squamous cell carcinoma (EAC-SCC) is still a major cause of recurrence. The aim of this study is to examine the clinical impact of positive-margin resection of EAC-SCCs. METHODS We retrospectively reviewed 40 surgical cases with en bloc temporal bone resection of EAC-SCC at a tertiary referral center from October 2016 to March 2022. RESULTS Two-year disease-specific, overall, and disease-free survival rates for all 40 cases reviewed were 85.2%, 88.85%, and 76.96%, respectively. En bloc resection with a negative margin significantly improved patient prognosis (p < 0.001). Positive-margin resection was observed in 9/40 cases (22.5%). Insufficient assessment of preoperative images was the cause in two of these cases. Postoperative lymph node metastasis and distant metastasis were observed in cases in which vascular, lymphatic duct or perineural invasion was found on postoperative pathological examination. In addition, three cases in which no vascular, lymphatic duct, or perineural invasion was found exhibited local recurrence during the follow-up period. Of the nine positive-margin resection cases, only two showed no postoperative recurrence. CONCLUSIONS Once positive-margin resections are confirmed, cases might have a high risk of tumor recurrence, even with the addition of postoperative adjuvant chemoradiotherapy.
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Affiliation(s)
- Noritaka Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (R.K.); (T.H.); (K.S.); (T.N.)
| | - Ryosuke Kuga
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (R.K.); (T.H.); (K.S.); (T.N.)
- Department of Anatomic Pathology, Pathological, Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Takahiro Hongo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (R.K.); (T.H.); (K.S.); (T.N.)
| | - Daisuke Kuga
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan;
| | - Kuniaki Sato
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (R.K.); (T.H.); (K.S.); (T.N.)
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan; (R.K.); (T.H.); (K.S.); (T.N.)
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Nabuurs CH, Kievit W, Leemans CR, Smit CFGM, van den Brekel MWM, Pauw RJ, van der Laan BFAM, Jansen JC, Lacko M, Braunius WW, Dai C, Shi X, Danesi G, Bouček J, Takes RP, Kunst HPM. Evaluation of subclasses for T4-classified squamous cell carcinoma of the external auditory canal. Head Neck 2022; 44:1787-1798. [PMID: 35560966 PMCID: PMC9541903 DOI: 10.1002/hed.27082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/02/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
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.
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Affiliation(s)
- Cindy H Nabuurs
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Wietske Kievit
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Department of Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C René Leemans
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam University Medical Centers, VU University, Amsterdam, the Netherlands
| | - Conrad F G M Smit
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam University Medical Centers, VU University, Amsterdam, the Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Robert J Pauw
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery, Haaglanden Medical Center, The Hage, the Netherlands
| | - Jeroen C Jansen
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Martin Lacko
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Weibel W Braunius
- Department of Head and Neck Surgical Oncology, University Medical Center/Utrecht Cancer Center, Utrecht, the Netherlands
| | - Chunfu Dai
- Department of Otology & Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China
| | - Xunbei Shi
- Department of Otology & Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China
| | - Giovanni Danesi
- Department of Otorhinolaryngology and Skull Base Microsurgery-Neurosciences, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Jan Bouček
- Department of Otorhinolaryngology and Head and Neck Surgery, The First Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czech Republic
| | - Robert P Takes
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Henricus P M Kunst
- Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, Nijmegen, the Netherlands.,Rare Cancers, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery - Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Maastricht University Medical Center, Maastricht, the Netherlands
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Yamazaki H, Suzuki G, Aibe N, Shiomi H, Oh RJ, Yoshida K, Nakamura S, Ogita M. Reirradiation for Rare Head and Neck Cancers: Orbit, Auditory Organ, and Salivary Glands. Cureus 2022; 14:e22727. [PMID: 35308727 PMCID: PMC8920751 DOI: 10.7759/cureus.22727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
We analyzed the efficacy and toxicity following reirradiation for locoregional recurrence of rare head and neck tumors. We retrospectively analyzed 17 patients who had received reirradiation for rare head and neck tumors. Primary tumor sites included nine ears (auditory organ), four salivary glands, and four orbits. The median follow-up time was 13.2 months for surviving patients. The median survival time was 12.6 months with one- and two-year survival rates of 53.1% and 44.3%, respectively. Nine out of 17 patients experienced local failure. The one- and two-year local control rates were 42.4% and 31.8%, respectively. The median survival times were 12.6, 5.3, and 11.0 months for orbit, auditory organ, and salivary glands, respectively. Three patients experienced grade 3 toxicity, including meningitis, brain necrosis, and facial nerve disorders. No grade ≥4 toxicities were observed. Reirradiation of rare head and neck tumors is feasible, with acceptable toxicity.
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6
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Nishio N, Okazaki Y, Wada A, Tsuzuki H, Kambe M, Fujimoto Y, Sone M. Management of bilateral locally advanced squamous cell carcinoma of the external auditory canal. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2022. [DOI: 10.1080/23772484.2022.2033122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuriko Okazaki
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihisa Wada
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidenori Tsuzuki
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Miki Kambe
- Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Nagakute, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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7
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Saijo K, Ueki Y, Tanaka R, Yokoyama Y, Omata J, Takahashi T, Ota H, Shodo R, Yamazaki K, Togashi T, Okabe R, Matsuyama H, Honda K, Sato Y, Morita Y, Takahashi K, Horii A. Treatment Outcome of External Auditory Canal Carcinoma: The Utility of Lateral Temporal Bone Resection. Front Surg 2021; 8:708245. [PMID: 34527695 PMCID: PMC8435738 DOI: 10.3389/fsurg.2021.708245] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022] Open
Abstract
We examined the role of lateral temporal bone resection (LTBR) in the treatment of external ear canal (EAC) carcinoma between 2007 and 2018. The estimated 3-year disease-free survival (DFS) and disease-specific survival (DSS) according to the tumor stage and treatments were investigated in 36 patients with EAC squamous cell carcinoma. T stage classification according to the University of Pittsburgh staging system was as follows: 14 patients in T1, four patients in T2, nine patients in T3, and nine patients in T4. The 3-year DFS rate was 77.4% for T1 tumors, 100% for T2, 44.4% for T3 tumors, and 11.1% for T4 tumors (p < 001). The 3-year DSS rate was 100% for T1/T2 tumors, 87.5% for T3 tumors, and 11.1% for T4 tumors (p < 0.01). T1/T2 patients received mostly LTBR. Among nine T3 tumors, five patients (56%) received LTBR combined with preoperative chemotherapy and/or postoperative radiation (RT). Four of them had negative surgical margin and survived with no evidence of disease. The DFS of T3 patients who underwent concurrent chemoradiotherapy and LTBR was 0 and 80%, respectively (p = 0.048). For T1/T2 tumors, surgery achieved an excellent outcome. For T3 tumors, LTBR achieved negative surgical margin and showed good survival when combined with preoperative chemotherapy and/or postoperative RT. In contrast, the prognosis of T3 patients who could not undergo surgery was as poor as that of T4 patients. Therefore, in addition to subtotal temporal bone resection, LTBR-based treatment strategy may be a treatment option for limited cases of T3 patients.
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Affiliation(s)
- Kohei Saijo
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yushi Ueki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ryoko Tanaka
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yusuke Yokoyama
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jo Omata
- Department of Otolaryngology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Takeshi Takahashi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hisayuki Ota
- Department of Otolaryngology, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Ryusuke Shodo
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keisuke Yamazaki
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takafumi Togashi
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Ryuichi Okabe
- Department of Otolaryngology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Hiroshi Matsuyama
- Department of Otolaryngology, Niigata General Hospital, Niigata, Japan
| | - Kohei Honda
- Department of Otolaryngology, Niigata Prefectural Central Hospital, Joetsu, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yuka Morita
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kuniyuki Takahashi
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Arata Horii
- Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Phase I trial of concurrent chemoradiotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF-CRT) for locally advanced squamous cell carcinoma of the external auditory canal. Eur Arch Otorhinolaryngol 2021; 279:2805-2810. [PMID: 34263358 DOI: 10.1007/s00405-021-06974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Chemoradiotherapy with docetaxel (DOC), cisplatin (CDDP), and 5-FU (TPF-CRT) for locally advanced external auditory canal cancer (EACC) has favorable oncological and functional outcomes. To establish TPF-CRT as a standard of care for advanced EACC, we conducted this study to determine the maximum tolerated (MTD) and recommended dose (RD) of DOC in TPF-CRT for locally advanced EACC. METHODS To determine the recommended (RD) and maximum tolerated dose (MTD) of DOC in TPF-CRT for EACC, a phase I trial was conducted using the standard "3 + 3" design for maximum dose finding. DOC was administered twice every 4 weeks, CDDP at 70 mg/m2 and 5-FU at 700 mg/m2; patients were also receiving radiotherapy (66 Gy). Eight patients with T3 or T4 EACC were prospectively enrolled. RESULTS Two patients treated with DOC, 50 mg/m2, and one out of six patients treated with DOC, 40 mg/m2, had dose-limiting toxicities. Prolonged febrile neutropenia was observed in three patients. Grade 3 non-hematological toxicities were observed in only three patients. At study completion, six patients survived, five of whom were disease free. CONCLUSION The RD and MTD of DOC in TPF-CRT for locally advanced EACC are 40 mg/m2 when doses of CDDP and 5-FU are 70 mg/m2 and 700 mg/m2, respectively.
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Temporal bone carcinoma: testing the prognostic value of a novel clinical and histological scoring system. Eur Arch Otorhinolaryngol 2020; 278:4179-4186. [PMID: 33231758 DOI: 10.1007/s00405-020-06489-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Our group recently proposed the novel Padova prognostic scoring system for temporal bone carcinoma (TBSCC) that considers: the revised Pittsburgh staging system; radiological dura mater involvement; non-anterior spread (medial, inferior or posterior into the temporal bone and skull base) of T4 tumors; and histological grade. The aim of the present study was to validate this prognostic TBSCC scoring system in a case series selected from the literature. METHODS A search was run to identify studies on TBSCC reporting the variables included in our score for each patient. Then our system was applied to the data extracted. RESULTS Only two published investigations reported all the clinical and pathological data required for our scoring system. In one series from the Gruppo Otologico in Piacenza (Italy), a significantly higher recurrence rate (p = 0.008), shorter disease-free survival (DFS) (p = 0.001), higher disease-specific mortality (DSM) (p = 0.006), and shorter disease-specific survival (DSS) (p = 0.004) were associated with scores ≥ 5. Receiver operating curve (ROC) analysis showed an AUC of 0.804 for TBSCC recurrence, and 0.832 for DSM. In a series from Kyushu University Hospital (Japan), a significantly higher DSM (p = 0.018) and shorter DSS (p = 0.021) were associated with scores ≥ 5. ROC analysis showed an AUC of 0.812 for tumor relapse and 0.790 for DSM. CONCLUSION Our TBSCC Padova scoring system confirmed its validity when applied to the only two international TBSCC series providing the required data. These preliminary results need to be confirmed in a multi-center prospective setting.
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