Cutaneous squamous cell carcinoma of the external auditory meatus: An entity of its own?

Objectives:

Involvement of the external auditory meatus (EAM) in cutaneous squamous cell carcinoma (SCC) is associated with poor survival. This study assesses oncological parameters and immunosuppression as underlying risk factors.

Methods:

136 patients (31 EAM, 60 with ear SCC, 45 with SCC of the face) were included in the current study. Oncological parameters and immunosuppressive comorbidity were retrospectively assessed.

Results:

SCC with EAM involvement showed increased T/N-status when compared with all other subgroups. EAM involvement is associated with a 1.2-fold increased risk of tumor recurrency (p = 0.016), while increased T/N status resulted in a 1.8/2.5-fold increased risk of tumor associated death. After adjustment according to the T/N status overall survival in EAM patients was comparable with all other tumor locations. Immunosuppressive status was diagnosed in 25% of patients, including patients with diabetes mellitus, haematological diseases, and prior organ transplantation. However, Cox-regression analysis revealed that an immunosuppressive comorbidity did not influence recurrence-free time or overall survival.

Conclusion:

Patients with EAM SCC showed significantly increased T/N status at the time of diagnosis resulting in an increased risk of tumor recurrency. Adjustment of the overall cohort according to the T/N status showed that poor survival of EAM patients is due to increased T/N status rather than a distinct oncological behaviour. Immunosuppressive status was not associated with a worse overall survival or tumor recurrence.

Publication History

Publication Date:
23 April 2019 (online)