Squamous cell carcinomas of the ear: Factors of gravity and surgical treatment, about 30cases [Carcinomes spinocellulaires de l'oreille: Facteurs de gravité et traitement chirurgical, à propos de 30cas]

摘要

Introduction: Squamous cell carcinomas (SCC) of the ear are known for their aggressiveness. The aim of this study was to investigate factors of gravity while freeing the therapeutic requirements. Patients and methods: This is a retrospective study of 28patients (30ears) operated for SCC. The characteristics of the lesion, the presence of metastasis, treatment modalities and histologic findings were collected. Local recurrences and metastasis are identified with a mean follow-up time of 37. months (17-110. months). Results: The lesion size was less than 2. cm in 19cases (63.3%) and greater than or equal to 2. cm in 11cases (36.7%). Macroscopic resection margins were 5, 7 or 10. mm. The resections were histologically incomplete in 4cases (13%) requiring further surgery. Six cases had local recurrence (20%): three with pulmonary or lymph node metastases (10%) and one death (3.3%). In these 6cases of recurrence, the surgical margins were 6.3. mm on average, the initial lesion measured always greater than 2. cm (100%). Three quarters of incomplete resections have recurrent despite a surgical revision in healthy margin. Conclusion: Our study confirms the data of literature, namely the pejorative character of a lesion greater than 2. cm and incomplete resection. The HAS recommendations seem minimal regarding the ear. In case of injury by more than 2. cm and with a proximal location on the ear pinna, only amputation of the ear allows satisfactory cancer control.