A retrospective analysis of histological prognostic factors for the development of lymph node metastases from auricular squamous cell carcinoma.
OBJECTIVE
Squamous cell carcinoma (SCC) of the auricle has a high risk of metastatic spread, which is associated with high mortality. Identification of patients with a high risk of lymph node metastases would allow prophylactic treatment to the draining lymph nodes, but there are no established clinical or histopathological criteria to predict which tumours have a high risk of metastasis. The aim was to determine such criteria.


RESULTS
The study was a retrospective analysis of the clinical and histological features of 229 cases of SCC of the auricle, with a minimum of 2 years' clinical follow-up. Overall, lymph node metastases were present in 24 cases (10.5%). Of the patients with metastatic disease 66.7% died, despite multi-modality treatment. Tumours with a depth of invasion >8 mm or a depth of invasion between 2 and 8 mm in conjunction with evidence of destructive cartilage invasion, lymphovascular invasion or a non-cohesive invasive front had a high risk of metastasis (56% and 24%, respectively).


CONCLUSIONS
Patients with high-risk tumours, as assessed histopathologically, should be considered for prophylactic therapy to or staging of the regional lymph nodes.
Clark
Richard R
RR
Department of Plastic Surgery, Ninewells Hospital Dundee, Dundee, UK. rrclark@canniesburn.org
Soutar
David S
DS
Hunter
Keith D
KD
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D004425:Ear Cartilage / Q000473:pathology; D004428:Ear Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology / Q000517:prevention & control; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology