Long-term results of treatment for patients with locally advanced external ear skin cancer

The study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer.Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are...

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Main Authors: A. M. Mudunov, E. G. Khazarova, M. V. Bolotin
Format: Article
Language:Russian
Published: ABV-press 2021-04-01
Series:Опухоли головы и шеи
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Online Access:https://ogsh.abvpress.ru/jour/article/view/607
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author A. M. Mudunov
E. G. Khazarova
M. V. Bolotin
author_facet A. M. Mudunov
E. G. Khazarova
M. V. Bolotin
author_sort A. M. Mudunov
collection DOAJ
description The study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer.Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median 12.0 months). We divided patients into 3 groups depending on treatment methods. Group 1 consisted of patients who received combined or complex treatment (33.3 %, n = 15). Treatment for first group patients involved subtotal, lateral temporal bone resection or incomplete lateral resection and postoperative radiation therapy on the area of primary tumor and regional metastasis zone (total focal dose from 60 Gy). In the case of complex treatment, radiation therapy had carried out against background cisplatin introduction. The second group consisted of patients who received only surgical treatment (40.0 %, n = 18). Temporal bone resections were not performed for patients of the third group (26.7 %, n = 12). Treatment for patients of the third group involved one of the treatment methods: cryodestruction, laser destruction, photodynamic therapy, radiotherapy or chemoradiation treatment.Results. Five-year survival without signs of progression in a group of patients with locally advanced of the ear skin cancer, who received combined or complex treatment was 73.8 ± 13.1. Median progression-free survival not achieved. In the surgical treatment group 5 year progression-free survival was 40.4 ± 13.0, median was 34.1 months. In a group of patients who did not undergo temporal bone resection (3rd group) median progression-free survival was 4.5 months. Group differences are statistically significant (p <0.05). The most significant adverse prognosis factors that reduce overall survival for patients with locally advanced external ear skin cancer are positive histological margin (p = 0.0001, hazard ratio (HR) = 10.611, 95 % confidence interval (CI) 3.058-36.820), signs of destruction branch of the lower jaw/ zygomatic bone (p = 0.027, HR = 4.65, 95 % CI 1.193-18.116). Facial paralysis is the most unfavorable prognosis factor, reducing tumor-specific survival in patients with locally advanced outer ear skin cancer (p = 0.0001, HR = 19.146, 95 % CI 4.056-90.388).Conclusion. Combined/complex treatment of patients with locally advanced ear skin cancer (surgery with postoperative radiotherapy/chemoradiotherapy) provides better long-term results compared to other treatment options.
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series Опухоли головы и шеи
spelling doaj-art-d76a50b94063452b907c975043a976e22025-08-20T03:01:11ZrusABV-pressОпухоли головы и шеи2222-14682411-46342021-04-01111122310.17650/2222-1468-2021-11-1-12-23426Long-term results of treatment for patients with locally advanced external ear skin cancerA. M. Mudunov0E. G. Khazarova1M. V. Bolotin2I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia; N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaI.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaThe study objective is to assess long-term results of treatment for patients with locally advanced external ear skin cancer.Materials and methods. This research work based on a retrospective and prospective analysis case history for patients with locally advanced external ear skin cancer. These are 45 patients, who received treatment in surgical department of head and neck tumors in Blokhin National Medical Research Center of Oncology between 1994 and 2020. Patient observation time averaged 30.0 ± 32.3 months (from 0.7 to 117.4 months, median 12.0 months). We divided patients into 3 groups depending on treatment methods. Group 1 consisted of patients who received combined or complex treatment (33.3 %, n = 15). Treatment for first group patients involved subtotal, lateral temporal bone resection or incomplete lateral resection and postoperative radiation therapy on the area of primary tumor and regional metastasis zone (total focal dose from 60 Gy). In the case of complex treatment, radiation therapy had carried out against background cisplatin introduction. The second group consisted of patients who received only surgical treatment (40.0 %, n = 18). Temporal bone resections were not performed for patients of the third group (26.7 %, n = 12). Treatment for patients of the third group involved one of the treatment methods: cryodestruction, laser destruction, photodynamic therapy, radiotherapy or chemoradiation treatment.Results. Five-year survival without signs of progression in a group of patients with locally advanced of the ear skin cancer, who received combined or complex treatment was 73.8 ± 13.1. Median progression-free survival not achieved. In the surgical treatment group 5 year progression-free survival was 40.4 ± 13.0, median was 34.1 months. In a group of patients who did not undergo temporal bone resection (3rd group) median progression-free survival was 4.5 months. Group differences are statistically significant (p <0.05). The most significant adverse prognosis factors that reduce overall survival for patients with locally advanced external ear skin cancer are positive histological margin (p = 0.0001, hazard ratio (HR) = 10.611, 95 % confidence interval (CI) 3.058-36.820), signs of destruction branch of the lower jaw/ zygomatic bone (p = 0.027, HR = 4.65, 95 % CI 1.193-18.116). Facial paralysis is the most unfavorable prognosis factor, reducing tumor-specific survival in patients with locally advanced outer ear skin cancer (p = 0.0001, HR = 19.146, 95 % CI 4.056-90.388).Conclusion. Combined/complex treatment of patients with locally advanced ear skin cancer (surgery with postoperative radiotherapy/chemoradiotherapy) provides better long-term results compared to other treatment options.https://ogsh.abvpress.ru/jour/article/view/607outer ear skin cancertemporal bone resectionlong-term treatment results
spellingShingle A. M. Mudunov
E. G. Khazarova
M. V. Bolotin
Long-term results of treatment for patients with locally advanced external ear skin cancer
Опухоли головы и шеи
outer ear skin cancer
temporal bone resection
long-term treatment results
title Long-term results of treatment for patients with locally advanced external ear skin cancer
title_full Long-term results of treatment for patients with locally advanced external ear skin cancer
title_fullStr Long-term results of treatment for patients with locally advanced external ear skin cancer
title_full_unstemmed Long-term results of treatment for patients with locally advanced external ear skin cancer
title_short Long-term results of treatment for patients with locally advanced external ear skin cancer
title_sort long term results of treatment for patients with locally advanced external ear skin cancer
topic outer ear skin cancer
temporal bone resection
long-term treatment results
url https://ogsh.abvpress.ru/jour/article/view/607
work_keys_str_mv AT ammudunov longtermresultsoftreatmentforpatientswithlocallyadvancedexternalearskincancer
AT egkhazarova longtermresultsoftreatmentforpatientswithlocallyadvancedexternalearskincancer
AT mvbolotin longtermresultsoftreatmentforpatientswithlocallyadvancedexternalearskincancer