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Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis

  • Head and Neck
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Abstract

Purpose

The prognostic significance of auricular location in cutaneous squamous cell carcinoma (cSCC) is controversial. We aimed to characterize risk factors for, and evaluate the cumulative incidence of, locoregional recurrence in a cohort of patients with primary auricular cSCC.

Methods

The study design was a single-institution retrospective cohort review from 1/2007 to 12/2016.

Results

Among 851 potentially eligible individuals, 178 patients with primary auricular cSCC met strict criteria for inclusion. Median follow-up was 32 months, 93% were AJCC 8th edition (AJCC8) stage I and 6% were AJCC8 stage II. Most underwent Mohs micrographic surgery (MMS; 97%) and the remainder underwent wide local excision ± parotidectomy ± neck dissection ± adjuvant therapy (3%). Recurrences occurred in seven patients (4%): six were local and one was regional. The 3-year cumulative incidence of local and regional recurrence for AJCC8 stage I–II tumors were 1% (95% CI 0–5%) and 0%, respectively. Among ten patients upstaged to pT3 disease who underwent MMS alone, none recurred locoregionally. Compared to their respective counterparts, advanced stage, PNI, and LVI associated with a significantly increased risk of locoregional recurrence.

Conclusions

Our findings suggest that auricular location may not be a significant risk factor for cSCC staging systems. In the absence of other risk factors, unimodal therapy appears adequate for patients with primary, stage I–II auricular cSCC. The prognostic significance of pT3 auricular cSCC stage due to depth of invasion alone should be evaluated further.

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Availability of data and material

Available upon request.

Code availability

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References

  1. (NCCN) NCCN NCCN Clinical Practice Guidelines in Oncology. Squamous Cell Skin Cancer

  2. Karia PS, Morgan FC, Califano JA, Schmults CD (2018) Comparison of tumor classifications for cutaneous squamous cell carcinoma of the head and neck in the 7th vs 8th Edition of the AJCC cancer staging manual. JAMA Dermatol 154(2):175–181. https://doi.org/10.1001/jamadermatol.2017.3960

    Article  PubMed  Google Scholar 

  3. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP (2017) The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 67(2):93–99. https://doi.org/10.3322/caac.21388

    Article  PubMed  Google Scholar 

  4. Karia PS, Jambusaria-Pahlajani A, Harrington DP, Murphy GF, Qureshi AA, Schmults CD (2014) Evaluation of American Joint Committee on Cancer, International Union Against Cancer, and Brigham and Women’s Hospital tumor staging for cutaneous squamous cell carcinoma. J ClinOncol 32(4):327–334. https://doi.org/10.1200/jco.2012.48.5326

    Article  Google Scholar 

  5. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 147(8):573–577. https://doi.org/10.7326/0003-4819-147-8-200710160-00010

    Article  Google Scholar 

  6. Lansbury L, Bath-Hextall F, Perkins W, Stanton W, Leonardi-Bee J (2013) Interventions for non-metastatic squamous cell carcinoma of the skin: systematic review and pooled analysis of observational studies. BMJ (Clin Res Ed) 347:f6153. https://doi.org/10.1136/bmj.f6153

    Article  Google Scholar 

  7. Ruiz ES, Karia PS, Besaw R, Schmults CD (2019) Performance of the American Joint Committee on Cancer Staging Manual, 8th Edition vs the Brigham and Women’s Hospital Tumor Classification System for cutaneous squamous cell carcinoma. JAMA Dermatol 155(7):819–825. https://doi.org/10.1001/jamadermatol.2019.0032

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tschetter AJ, Campoli MR, Zitelli JA, Brodland DG (2020) Long-term clinical outcomes of patients with invasive cutaneous squamous cell carcinoma treated with Mohs micrographic surgery: a 5-year, multicenter, prospective cohort study. J Am AcadDermatol 82(1):139–148. https://doi.org/10.1016/j.jaad.2019.06.1303

    Article  Google Scholar 

  9. Thompson AK, Kelley BF, Prokop LJ, Murad MH, Baum CL (2016) Risk factors for cutaneous squamous cell carcinoma recurrence, metastasis, and disease-specific death: a systematic review and meta-analysis. JAMA Dermatol 152(4):419–428. https://doi.org/10.1001/jamadermatol.2015.4994

    Article  PubMed  PubMed Central  Google Scholar 

  10. Schmults CD, Karia PS, Carter JB, Han J, Qureshi AA (2013) Factors predictive of recurrence and death from cutaneous squamous cell carcinoma: a 10-year, single-institution cohort study. JAMA Dermatol 149(5):541–547. https://doi.org/10.1001/jamadermatol.2013.2139

    Article  PubMed  Google Scholar 

  11. Brantsch KD, Meisner C, Schönfisch B, Trilling B, Wehner-Caroli J, Röcken M, Breuninger H (2008) Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study. Lancet Oncol 9(8):713–720. https://doi.org/10.1016/s1470-2045(08)70178-5

    Article  PubMed  Google Scholar 

  12. Kadakia S, Saman M, Gordin E, Marra D, Ducic Y (2015) The role of parotidectomy in the treatment of auricular squamous cell carcinoma. Otolaryngol Head Neck Surg 152(6):1048–1052. https://doi.org/10.1177/0194599815579885

    Article  PubMed  Google Scholar 

  13. Wermker K, Kluwig J, Schipmann S, Klein M, Schulze HJ, Hallermann C (2015) Prediction score for lymph node metastasis from cutaneous squamous cell carcinoma of the external ear. Eur J SurgOncol 41(1):128–135. https://doi.org/10.1016/j.ejso.2014.07.039

    Article  CAS  Google Scholar 

  14. Osborne RF, Shaw T, Zandifar H, Kraus D (2008) Elective parotidectomy in the management of advanced auricular malignancies. Laryngoscope 118(12):2139–2145. https://doi.org/10.1097/MLG.0b013e318182c30b

    Article  PubMed  Google Scholar 

  15. Porceddu SV, Bressel M, Poulsen MG, Stoneley A, Veness MJ, Kenny LM, Wratten C, Corry J, Cooper S, Fogarty GB, Collins M, Collins MK, Macann AMJ, Milross CG, Penniment MG, Liu HY, King MT, Panizza BJ, Rischin D (2018) Postoperative concurrent chemoradiotherapy versus postoperative radiotherapy in high-risk cutaneous squamous cell carcinoma of the head and neck: the randomized phase III TROG 05.01 trial. J ClinOncol 36(13):1275–1283. https://doi.org/10.1200/jco.2017.77.0941

    Article  CAS  Google Scholar 

  16. Likhacheva A, Awan M, Barker CA, Bhatnagar A, Bradfield L, Brady MS, Buzurovic I, Geiger JL, Parvathaneni U, Zaky S, Devlin PM (2020) Definitive and postoperative radiation therapy for basal and squamous cell cancers of the skin: executive summary of an American Society for Radiation Oncology Clinical Practice Guideline. PractRadiatOncol 10(1):8–20. https://doi.org/10.1016/j.prro.2019.10.014

    Article  Google Scholar 

  17. Wermker K, Belok F, Schipmann S, Klein M, Schulze HJ, Hallermann C (2015) Prediction model for lymph node metastasis and recommendations for elective neck dissection in lip cancer. J CranioMaxilloFacSurg 43(4):545–552. https://doi.org/10.1016/j.jcms.2015.02.002

    Article  Google Scholar 

  18. Veness MJ (2007) High-risk cutaneous squamous cell carcinoma of the head and neck. J Biomed Biotechnol 2007(3):80572–80572. https://doi.org/10.1155/2007/80572

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, 2001 Inwood Road, Dallas, TX, 75390, USA

    Priscilla J. Tanamal, Calvin X. Geng, Erin Wynings, Sanjana Balachandra, Larry L. Myers, Brittny N. Tillman & Andrew T. Day

  2. Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, USA

    Rajiv I. Nijhawan

Authors
  1. Priscilla J. Tanamal
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  2. Calvin X. Geng
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  3. Rajiv I. Nijhawan
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  4. Erin Wynings
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  5. Sanjana Balachandra
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  6. Larry L. Myers
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  7. Brittny N. Tillman
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  8. Andrew T. Day
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Contributions

All authors contribute to the study conception and design. Data collection and analysis were performed by PT, CG, RIN and ATD. The first draft of the manuscript was written by PT and ATD. All authors critically reviewed, edited and approved the final manuscript.

Corresponding author

Correspondence to Andrew T. Day.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This retrospective cohort study involving human participants approved by the Institutional Review Board at the UT Southwestern Medical Center (STU 122016-038).

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Not applicable as this was a retrospective cohort study approved by the IRB and all published information is de-identified.

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Not applicable as all published information is de-identified.

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Appendix

Appendix

See Table 2.

Table 2 Univariate analysis of selected risk factors for locoregional recurrence
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Tanamal, P.J., Geng, C.X., Nijhawan, R.I. et al. Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis. Eur Arch Otorhinolaryngol 279, 335–341 (2022). https://doi.org/10.1007/s00405-021-06763-z

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  • DOI: https://doi.org/10.1007/s00405-021-06763-z

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