Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy

IntroductionCarcinoma of the external auditory canal (EAC) is rare, and squamous cell carcinoma (SCC) is the most common histological type. There are few reports on the treatment outcomes for a large number of cases at a single institution, and a standard treatment has not been established.MethodsTr...

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Main Authors: Yosuke Mizunari, Masato Nagaoka, Naohiro Takeshita, Kazuki Kanno, Haruyuki Hirayama, Taisuke Akutsu, Hisashi Kessoku, Katsuhiro Ishida, Yutaka Yamamoto
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1530922/full
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author Yosuke Mizunari
Masato Nagaoka
Naohiro Takeshita
Kazuki Kanno
Haruyuki Hirayama
Taisuke Akutsu
Hisashi Kessoku
Katsuhiro Ishida
Yutaka Yamamoto
author_facet Yosuke Mizunari
Masato Nagaoka
Naohiro Takeshita
Kazuki Kanno
Haruyuki Hirayama
Taisuke Akutsu
Hisashi Kessoku
Katsuhiro Ishida
Yutaka Yamamoto
author_sort Yosuke Mizunari
collection DOAJ
description IntroductionCarcinoma of the external auditory canal (EAC) is rare, and squamous cell carcinoma (SCC) is the most common histological type. There are few reports on the treatment outcomes for a large number of cases at a single institution, and a standard treatment has not been established.MethodsTreatment details and prognoses were retrospectively examined for patients who underwent primary treatment for SCC of the EAC at The Jikei University between April 2015 and May 2023.ResultsTwenty-seven patients with SCC of the EAC were included (median age of 64 years). Analysis using the revised Pittsburgh classification revealed that there were 3 cases of T1, 4 cases of T2, 9 cases of T3, and 11 cases of T4. Among the patients, 13 were treated surgically, 1 underwent partial resection of the EAC, 11 underwent lateral temporal bone resection, and 1 underwent subtotal temporal bone resection. The remaining 14 patients received nonsurgical treatment: 1 with radiotherapy, 3 with concurrent chemoradiotherapy, and 10 with induction chemotherapy (ICT). The overall survival (OS) and disease-free survival (DFS) rates at 3 years were 72.8% and 50.5%, respectively. When the surgical and non-surgical groups were compared, the 3-year OS and DFS rates were 92.3% and 68.3% for those who underwent surgery and 47.6% and 35.7% for those not treated with surgery, respectively, suggesting a better prognoses for patients who underwent surgical treatments (p = 0.045, 0.052). In the non-surgical group, the 3-year OS and DFS rates were 90.0% and 50.0% for those who received ICT and 0% and 0% for those who did not receive ICT, respectively, indicating better prognoses for patients treated with ICT (p = 0.0075, 0.0012).ConclusionAt our institution, the 3-year OS and DFS rates of patients with SCC of the EAC were favourable for those who underwent surgery and received ICT. These findings suggest that treatment outcomes can be improved by using ICT in nonsurgical treatments for patients with SCC of the EAC.
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publisher Frontiers Media S.A.
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spelling doaj-art-80bc0ccdf4a64eefa7cc769d45011a912025-08-20T03:36:42ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.15309221530922Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapyYosuke Mizunari0Masato Nagaoka1Naohiro Takeshita2Kazuki Kanno3Haruyuki Hirayama4Taisuke Akutsu5Hisashi Kessoku6Katsuhiro Ishida7Yutaka Yamamoto8Department of Otolaryngology, The Jikei University Kashiwa Hospital, Kashiwa, JapanDepartment of Otolaryngology, The Jikei University School of Medicine, Tokyo, JapanDepartment of Otolaryngology, The Jikei University School of Medicine, Tokyo, JapanDepartment of Otolaryngology, The Jikei University School of Medicine, Tokyo, JapanDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, JapanDepartment of Otolaryngology, The Jikei University School of Medicine, Tokyo, JapanDepartment of Otolaryngology, The Jikei University Kashiwa Hospital, Kashiwa, JapanDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, JapanDepartment of Otolaryngology, The Jikei University School of Medicine, Tokyo, JapanIntroductionCarcinoma of the external auditory canal (EAC) is rare, and squamous cell carcinoma (SCC) is the most common histological type. There are few reports on the treatment outcomes for a large number of cases at a single institution, and a standard treatment has not been established.MethodsTreatment details and prognoses were retrospectively examined for patients who underwent primary treatment for SCC of the EAC at The Jikei University between April 2015 and May 2023.ResultsTwenty-seven patients with SCC of the EAC were included (median age of 64 years). Analysis using the revised Pittsburgh classification revealed that there were 3 cases of T1, 4 cases of T2, 9 cases of T3, and 11 cases of T4. Among the patients, 13 were treated surgically, 1 underwent partial resection of the EAC, 11 underwent lateral temporal bone resection, and 1 underwent subtotal temporal bone resection. The remaining 14 patients received nonsurgical treatment: 1 with radiotherapy, 3 with concurrent chemoradiotherapy, and 10 with induction chemotherapy (ICT). The overall survival (OS) and disease-free survival (DFS) rates at 3 years were 72.8% and 50.5%, respectively. When the surgical and non-surgical groups were compared, the 3-year OS and DFS rates were 92.3% and 68.3% for those who underwent surgery and 47.6% and 35.7% for those not treated with surgery, respectively, suggesting a better prognoses for patients who underwent surgical treatments (p = 0.045, 0.052). In the non-surgical group, the 3-year OS and DFS rates were 90.0% and 50.0% for those who received ICT and 0% and 0% for those who did not receive ICT, respectively, indicating better prognoses for patients treated with ICT (p = 0.0075, 0.0012).ConclusionAt our institution, the 3-year OS and DFS rates of patients with SCC of the EAC were favourable for those who underwent surgery and received ICT. These findings suggest that treatment outcomes can be improved by using ICT in nonsurgical treatments for patients with SCC of the EAC.https://www.frontiersin.org/articles/10.3389/fonc.2025.1530922/fullsquamous cell carcinomaexternal auditory canalrevised Pittsburgh classificationoverall survivaldisease-free survivalinduction chemotherapy
spellingShingle Yosuke Mizunari
Masato Nagaoka
Naohiro Takeshita
Kazuki Kanno
Haruyuki Hirayama
Taisuke Akutsu
Hisashi Kessoku
Katsuhiro Ishida
Yutaka Yamamoto
Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
Frontiers in Oncology
squamous cell carcinoma
external auditory canal
revised Pittsburgh classification
overall survival
disease-free survival
induction chemotherapy
title Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
title_full Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
title_fullStr Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
title_full_unstemmed Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
title_short Treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
title_sort treatment outcomes of squamous cell carcinoma of the external auditory canal and potential benefit of induction chemotherapy followed by chemoradiotherapy
topic squamous cell carcinoma
external auditory canal
revised Pittsburgh classification
overall survival
disease-free survival
induction chemotherapy
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1530922/full
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