耳部恶性肿瘤12例临床分析

Analysis of 12 patients with auricular malignancy

摘要:

目的 探讨耳部恶性肿瘤的治疗策略。方法 回顾性分析2014年3月—2020年12月收治的12例耳部恶性肿瘤患者的临床资料，其中鳞状细胞癌6例，腺样囊性癌6例；10例为初诊患者，根据改良匹兹堡分期标准，10例初诊患者中T1者1例，T3者3例，T4者6例，2例复发患者无法分期；4例手术切除，8例综合治疗(手术+放/化疗)。手术方式包括颞骨外侧切除术1例，颞骨次全切除术10例，颞下窝B型入路1例。利用生命表法计算生存率和Log-rank检验比较患者的生存差异。结果 随访8~53个月，3年生存率73%；单因素分析提示切缘阳性(P=0.033)与不良预后相关。结论 耳部恶性肿瘤发病率低且病程隐匿，手术切除结合术后放疗是有效的治疗方法。

关键词:外耳道;中耳;恶性肿瘤;手术;放疗;预后

Abstract:

Objective To explore the treatment strategy for auricular malignant neoplasms. Methods Clinical data of 12 cases with auricular malignant neoplasms treated from March 2014 to December 2020 were analyzed retrospectively. The pathological type included squamous cell carcinoma (n=6) and adenoid cystic carcinoma (n=6). According to the University of Pittsburgh-modified TNM staging system, 10 newly diagnosed patients included one patient at T1 stage, 3 at T3 stage and 6 at T4 stage. All patients underwent surgery with postoperative radiotherapy and/or chemotherapy in 8 of them. Surgical approaches included lateral temporal bone resection (n=1), subtotal temporal bone resection (n=10), and lateral skull base tumor resection via infratemporal fossa type B approach (n=1). Life table method was used to calculate the survival rate, and Log-rank test to compare the survival difference. Results Follow-up of period ranged from 8 to 53 months revealed that the 3-year overall survival rate was 73% and the positive margin (P=0.033) was associated with poor prognosis. Conclusions The incidence of auricular malignant neoplasm is low with insidious onset. Surgical resection combined with postoperative radiotherapy and/or chemotherapy may be an effective comprehensive treatment strategy.

Key words:External auditory canal;Middle ear;Malignant neoplasms;Surgery;Radiotherapy;Prognosis