Background: Positive-margin resection of external auditory canal squamous cell carcinoma (EAC-SCC) is still a major cause of recurrence. The aim of this study is to examine the clinical impact of positive-margin resection of EAC-SCCs. Methods: We retrospectively reviewed 40 surgical cases with en bloc temporal bone resection of EAC-SCC at a tertiary referral center from October 2016 to March 2022. Results: Two-year disease-specific, overall, and disease-free survival rates for all 40 cases reviewed were 85.2%, 88.85%, and 76.96%, respectively. En bloc resection with a negative margin significantly improved patient prognosis (p< 0.001). Positive-margin resection was observed in 9/40 cases (22.5%). Insufficient assessment of preoperative images was the cause in two of these cases. Postoperative lymph node metastasis and distant metastasis were observed in cases in which vascular, lymphatic duct or perineural invasion was found on postoperative pathological examination. In addition, three cases in which no vascular, lymphatic duct, or perineural invasion was found exhibited local recurrence during the follow-up period. Of the nine positive-margin resection cases, only two showed no postoperative recurrence. Conclusions: Once positive-margin resections are confirmed, cases might have a high risk of tumor recurrence, even with the addition of postoperative adjuvant chemoradiotherapy.
背景：外耳道鳞状细胞癌（EAC-SCC）切缘阳性仍是导致复发的主要原因。本研究旨在探讨EAC-SCC切缘阳性切除术的临床影响。方法：我们回顾性分析了2016年10月至2022年3月期间，在一家三级转诊中心接受整块颞骨切除术的40例EAC-SCC手术病例。结果：所有40例病例的两年疾病特异性生存率、总生存率和无病生存率分别为85.2%、88.85%和76.96%。切缘阴性的整块切除术显著改善了患者预后（p < 0.001）。在40例中，有9例（22.5%）观察到切缘阳性。其中两例的原因是术前影像评估不足。在术后病理检查中发现血管、淋巴管或神经周围侵犯的病例中，观察到术后淋巴结转移和远处转移。此外，有三例未发现血管、淋巴管或神经周围侵犯的病例在随访期间出现局部复发。在9例切缘阳性切除病例中，仅有两例术后未出现复发。结论：一旦确认切缘阳性，即使术后辅以放化疗，病例仍可能具有较高的肿瘤复发风险。
Impact of Positive-Margin Resection of External Auditory Canal Squamous Cell Carcinoma
肿瘤(癌症)患者之家