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Clinical outcome and prognostic factors in adenoid cystic carcinoma of the external auditory canal: proposal for a refined T-stage classification system

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Although adenoid cystic carcinoma (ACC) of the external auditory canal (EAC) has a different pathophysiology from squamous cell carcinoma, the same staging system is used. The aim of this study was to propose a refined staging system, which is more suitable for ACC of the EAC.

Methods

A total of 25 patients who were diagnosed with ACC of the EAC were reviewed. The modified Pittsburgh staging system (mPSS) that is universally used for temporal bone malignancy was refined for ACC (rPSS). The limited (< 0.5 cm) lateral soft tissue involvement was classified as T1 and extensive (≥ 0.5 cm) lateral soft tissue involvement as T2. The disease-free survival rate (DFSR) was assessed in the patients who underwent surgical treatment according to two staging systems; mPSS and rPSS.

Results

When staging using mPSS, most patients (96.0%, n = 24) were classified as T4. However, when rPSS was used, T1, T2, T3, and T4 stage occupied 36.0% (n = 9), 40.0% (n = 10), 12.0% (n = 3), 12.0% (n = 3), respectively. There was no difference in DFSR according to the T stage using mPSS (p = 0.466). However, when rPSS was used, the DFSR showed significant correlation with the T stage (p = 0.032).

Conclusions

Clinical T stage of mPSS was not sufficient to predict survival rate in ACC of the EAC, and we propose that the information on the lateral soft tissue involvement needs to be added to the existing staging system.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea

    Jung-Yup Lee & Yang-Sun Cho

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Contributions

J-YL and Y-SC had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Y-SC; acquisition, analysis, or interpretation of data: all authors; drafting of the manuscript: J-YL; critical revision of the manuscript for important intellectual content: all authors; statistical analysis: J-YL; administrative, technical, or material support: Y-SC; study supervision: Y-SC.

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Correspondence to Yang-Sun Cho.

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Lee, JY., Cho, YS. Clinical outcome and prognostic factors in adenoid cystic carcinoma of the external auditory canal: proposal for a refined T-stage classification system. Eur Arch Otorhinolaryngol 280, 3625–3633 (2023). https://doi.org/10.1007/s00405-023-07876-3

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  • DOI: https://doi.org/10.1007/s00405-023-07876-3

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