CAJ | 학술논문

目的总结外耳道和中耳鳞癌的分期方法及临床疗效.方法回顾性分析1990~2010年我院治疗的46例外耳道、中耳鳞癌患者资料,利用SPSS软件分析生存率、复发率及预后相关因素.结果46例患者中34例外耳道癌的5年生存率为62.4%,12例中耳癌为24.7%( P=0.004).中耳癌分期明显晚于外耳道癌,采用综合治疗的比例更高.早期外耳道癌5年生存率为85.6%,晚期为35.6%( P=0.002).多因素分析显示临床分期是外耳道癌的独立预后因素.外耳道癌中有15例出现复发,局部控制率为65.8%,肿瘤复发后患者生存率明显下降,复发后再治患者再次复发率高.结论早期的外耳道癌可选择单一治疗方法获得良好的生存,晚期外耳道癌病变应尽可能手术切除获得安全切缘,结合放疗提高治愈率,晚期中耳癌预后较差,建议采用乳突根治术结合放疗的综合治疗.
목적총결외이도화중이린암적분기방법급림상료효.방법회고성분석1990~2010년아원치료적46예외이도、중이린암환자자료,이용SPSS연건분석생존솔、복발솔급예후상관인소.결과46례환자중34예외이도암적5년생존솔위62.4%,12례중이암위24.7%( P=0.004).중이암분기명현만우외이도암,채용종합치료적비례경고.조기외이도암5년생존솔위85.6%,만기위35.6%( P=0.002).다인소분석현시림상분기시외이도암적독립예후인소.외이도암중유15례출현복발,국부공제솔위65.8%,종류복발후환자생존솔명현하강,복발후재치환자재차복발솔고.결론조기적외이도암가선택단일치료방법획득량호적생존,만기외이도암병변응진가능수술절제획득안전절연,결합방료제고치유솔,만기중이암예후교차,건의채용유돌근치술결합방료적종합치료.
Objective This is a review on the staging and treatment outcomes of external auditory canal (EAC) and middle ear carcinomas (ME). Methods Data from 46 patients treated in our hospital from 1990 to 2010 were reviewed ret?rospectively. Survival and local control rates were calculated with SPSS software. Results There were 34 patients with ECA and 12 with ME cancer in the study. The 5-year survival rates in patients with EAC and ME carcinomas were 62.4%and 24.7%( P=0.004), respectively. Patients with ME carcinomas had more advanced diseases and were more likely to receive combined treatments. Cervical lymph node metastasis predicted a poor survival. Clinical stage was the only independent prognostic factor of ECA cancer. Twenty three patients had at least one recurrence during the follow-up, including 15 with ECA and 8 with ME cancers. The local control rate of ECA cancer was 65.8%after salvage treatment. Patients with recur?rent disease had a high risk for another recurrence. Conclusion Patients with early stage ECA cancer can achieve good survival with either surgery or radiotherapy alone. Combined treatment and negative resection margin may indicate im?proved survival for patients with advanced EAC cancers. Patients with advanced middle ear cancer have poor survival in spite of extensive surgery. Radical mastoidectomy and postoperative radiotherapy are recommended for these patients to minimize treatment complications.