Managing squamous cell carcinoma of external auditory canal - A single institution experience.

External Auditory Canal (EAC) Squamous cell cancers are rare head and neck malignancies accounting for 0.2% of cancers of this region which has limited literature to guide management.We report a retrospective study patients with SCC of EAC treated at a Tertiary Cancer Centre in India.

Methodology: We have retrospectively reviewed the case files of patients with biopsy proven SCC of EAC treated at our Institute between 1st Jan 2005 to 31st Dec 2019. All patients were staged using TNM criteria and re-staged as per the Modified Pittsburg criteria and the NEW stage grouping proposed by George et al. The primary objectives of our analysis were estimation of Overall Survival (OS) and Disease Free Survival (DFS) and the secondary objectives included patterns of failure and evaluating factors affecting survival.

Results: Thirty-nine patients were included with a mean age of 55.5 years and 56% being female. More than 50% had stage I /II disease and 46% had stage III/ IV disease as per TNM criteria;10 patients underwent primary surgery.5 had adjuvant radiotherapy (RT) 24 underwent radical radiotherapy. The Median follow up of the group was 85 months with an OS of 70.7% (SE=7.9) and DFS of 47.4% (SE=8.2) at 5 years. Facial nerve palsy and the new staging grouping were found to be predictors of OS in multivariate analysis.

Conclusions: There is an unmet need for developing the optimal staging system that can best predict the outcomes for SCC of EAC. Early Stage disease can have good outcomes with either radiotherapy or surgery.