晚期外耳道腺样囊性癌患者临床特征分析OA
Clinical characteristics analysis of adenoid cystic carcinoma of external auditory canal in advanced stages
目的 总结分析晚期外耳道腺样囊性癌(adenoid cystic carcinoma,ACC)患者的临床资料,探讨其复发原因及诊疗策略.方法 回顾性纳入2021年1月至2023年12月于解放军总医院第六医学中心耳鼻咽喉头颈外科确诊为外耳道腺样囊性癌患者10例为研究对象,根据临床表现和影像学特征,选择合适的手术策略,术后随访并评估治疗效果.结果 10例晚期外耳道ACC患者,男4例,女6例,病程3～23年,首发临床表现为耳痛(9例)、外耳道包块(3例)、听力下降(3例)、耳溢液(2例)等.首次手术均于外院行外耳道肿瘤局部切除,于解放军总医院就诊时按Pittsburgh分期标准:T3患者1例,T4患者9例.远处转移者4例,行颞骨次全切或颞骨全切除术后回当地医院行放化疗6例.术后随访12～50个月,平均(34.7±12.7)个月,术后最短3个月复发,带瘤生存9例,无瘤生存1例.结论 晚期外耳道ACC首次手术选择外耳道肿瘤局部切除,术后肿瘤控制率低,短期内出现局部复发,预后差.首次手术至关重要,完整或扩大切除肿瘤联合术后放化疗,必要时辅以靶向治疗或免疫治疗可获得较好的预后.
Objective To report clinical outcomes of advanced external auditory canal adenoid cystic carcinoma(ACC),including causes of recurrence and management strategies.Methods Clinical data of 10 patients(4 males and 6 females)with ACC of the external auditory canal diagnosed at the General Hospital of the Chinese People's Liberation Army from January 2021 to December 2023 were retrospectively analyzed,including clinical manifestations,imaging characteristics,surgical strategies employed,postoperative follow-ups and outcomes.Results Disease duration ranged from 3 to 23 years.Initial clinical symptoms included earache(9 cases),external auditory canal mass(3 cases),hearing loss(3 cases)and otorrhea(2 cases).All cases had received local tumor resection at other hospitals.Based on the Pittsburgh classification,the lesion was T3 in 1 patient and T4 in 9.Four patients exhibited distant metastases,all in lungs.Six patients underwent subtotal or total temporal bone resection and subsequent radiotherapy and chemotherapy at local hospitals.The mean follow-up duration was(34.7±12.7)months,and the shortest recurrence time was 3 months.Nine patients survived with tumors,while 1 patient was tumor-free.Conclusions Local resection of external auditory canal tumor resulted in less favorable postoperative tumor control,with short-term local recurrence and poor prognosis.Both domestic and international guidelines for treating external auditory canal cancer state that the initial surgery is critical,emphasizing on complete or expanded tumor resection followed by radiotherapy and chemotherapy,supplemented when necessary with targeted therapy or immunotherapy to improve outcomes.
SAI Na;LU Jinshan;ZHENG Qiuchen;HAN Weiju;WANG Guojian;SHEN Weidong
Senior Department of Otolaryngology Head and Neck Surgery,the 6th Medical Center of Chinese PLA General Hospital,State Key Laboratory of Hearing and Balance Science,National Clinical Research Center for Otolaryngologic Diseases,Key Laboratory of Hearing Science,Ministry of Education,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Being 100853,ChinaDepartment of Otolaryngology,Afffliated Children's Hospital of Jiangnan University(Wuxi Children's Hospital),Wuxi 214000,ChinaDepartment of Otolaryngology-Head and Neck Surgery,Hainan Hospital of the Chinese People's Liberation Army General Hospital,Sanya 572010,ChinaSenior Department of Otolaryngology Head and Neck Surgery,the 6th Medical Center of Chinese PLA General Hospital,State Key Laboratory of Hearing and Balance Science,National Clinical Research Center for Otolaryngologic Diseases,Key Laboratory of Hearing Science,Ministry of Education,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Being 100853,ChinaSenior Department of Otolaryngology Head and Neck Surgery,the 6th Medical Center of Chinese PLA General Hospital,State Key Laboratory of Hearing and Balance Science,National Clinical Research Center for Otolaryngologic Diseases,Key Laboratory of Hearing Science,Ministry of Education,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Being 100853,ChinaSenior Department of Otolaryngology Head and Neck Surgery,the 6th Medical Center of Chinese PLA General Hospital,State Key Laboratory of Hearing and Balance Science,National Clinical Research Center for Otolaryngologic Diseases,Key Laboratory of Hearing Science,Ministry of Education,Beijing Key Laboratory of Hearing Impairment Prevention and Treatment,Being 100853,China
外耳道癌腺样囊性癌颞骨外侧切除术
external auditory canal carcinomaadenoid cystic carcinomalateral temporal bone resection
《中华耳科学杂志》 2026 (1)
9-13,5
北京市自然科学基金资助项目(青年项目7244412)
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