Abstract
Objectives
Carcinoma of the middle ear is a rare clinical entity, best suited for evaluation using a large, population-based database. The objective of this study was to utilize the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database to determine the incidence, treatment patterns, and survival of middle ear carcinoma.
Methods
Using SEER*Stat software, data for patients diagnosed between 1973–2004 were extracted based on the middle ear's anatomic code (C30.1). 5-year observed survival was analyzed with SPSS software, with significant differences determined by the Wilcoxon statistic.
Results
The 5-year survival rate for the 215 patients in this study was 36.4%. Histologic subtypes included squamous cell carcinoma (62.8%), adenocarcinoma (18.2%), other carcinomas (13.0%), and non-carcinomas (6.0%), with 5-year survival rates of 23.9%, 65.0%, 60.0%, and 38.6%, respectively (p=0.003). Of the 123 patients with known stage, 23.6% had local, 69.1% had regional, and 7.3% had distant disease, with their 5-year survival rates being 64.9%, 34.2%, and 0%, respectively (p=<0.001). Treatment included surgery (31.2%), radiation (16.3%), surgery and radiation (38.6%), or no treatment (8.4%) with 5-year survival of 69.2%, 14.6%, 26.4%, and 0%, respectively (p<0.001).
Conclusions
Patients with middle ear carcinoma have a relatively poor prognosis, reflected by a 5-year survival rate of 38.6%. However, subsets such as those with adenocarcinomas (65.0%) and with localized tumors (64.9%), demonstrated significantly better survival. Surgery alone had significantly better survival than the other treatment groups, presumably due to less advanced disease. These data are useful in counseling patients and understanding the natural history of middle ear carcinoma.
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