A retrospective analysis of treatment patterns and outcomes in carcinoma of the external auditory canal

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Objectives: Carcinoma of the external auditory canal (EAC) is a rare form of head and neck cancer, which accounts for <0.2% of the total head and neck cancer burden. The treatment typically involves a multidisciplinary approach, with surgery being the cornerstone for early-stage disease, while advanced-stage cases often require radiation therapy and chemotherapy. The presented retrospective analysis examines 15 patients to identify the optimal therapeutic strategies for managing EAC. Material and Methods: This retrospective analysis includes 15 patients from our institute. The key parameters analysed were age at presentation, histopathology, stage at diagnosis, treatment planning, treatment completion rates, and follow-up compliance. Results: A total of 15 patients received treatment, among whom the most common clinical presentations were swelling, bleeding, and discharge. Additional symptoms at the time of presentation included pain, ulcers, and hearing loss. Staging data were available for 87% of the patients, with 69% presenting with stage IV disease, 8% with stage III, and 23% with stage II. The median follow-up duration was 29 months (range: 25-30 months). During the follow-up period, one patient with stage II disease, three patients with stage IV disease, and one patient with an unknown stage of disease passed away. While stage III patients exhibited a 100% 3-year cumulative survival rate, those with stage II and stage IV disease had survival rates of 66.7% and 63.1%, respectively. However, the differences observed were not statistically significant ( p = 0.32). Conclusion: The treatment of carcinoma of the EAC was primarily surgical in early-stage disease, while advanced stages required a combined modality approach. Stage I and II diseases generally have a favourable prognosis, provided that surgery is feasible.

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