Treatment and outcome of middle ear cancer

This study addressed the clinical characteristics, treatment, and outcome of middle ear cancer. A series of 33 patients with middle ear cancer were analyzed with survival, the primary outcome. Altogether, 25 patients underwent surgery with adjuvant radiotherapy, seven patients had surgery alone, and one patient had only radiotherapy. The patients were staged according to the Stell staging system. Among patients with T₁/T₂ cancers, five underwent lateral temporal bone resection (LTBR) and three underwent subtotal temporal bone resection (STBR). Among those with T₃/T_x cancers, 11 underwent LTBR, and 13 had STBR. Of the total 33 patients, 18 died of their disease during follow-up. The overall 5-year survival rate was 37.4 %. The 5-year survival rates for patients with T₁/T₂ disease and T₃/T_x disease were 85.7 and 22.0 %, respectively. There was a statistically significant difference in 5-year survival rates between the two groups using the log-rank test (P < 0.05). The 5-year survival rates after LTBR and STBR for the T₃/T_x group were 15.2 and 30.8 % (P > 0.05), respectively, and those for the T₁/T₂ group were 100 and 66.7 % (P > 0.05), respectively. The 5-year survival rates for patients who underwent preoperative or postoperative radiotherapy were 38.9 and 40.4 %, respectively (P > 0.05). En bloc resection is favored in an effort to produce negative surgical margins for middle ear cancer. Adjunctive radiotherapy is used for advanced lesions.