title: Surgical margins and oncologic results after carcinoma of the external auditory canal.
abstract: OBJECTIVE
  External auditory canal cancer is rare and carries a poor prognosis. To date, only a few studies provide evidence for clinical decision making in multimodal treatment.
  
  
  METHODS
  Retrospective chart review of 36 cases in three tertiary referral centers.
  
  
  RESULTS
  Thirteen patients were treated by surgery alone, 18 by surgery with adjuvant chemoradiotherapy (CRT) and five by primary CRT. Clear surgical margins (R0) were obtained in 19 patients and positive margins (R1) in 12. The 5-year overall survival and local control rates were 59.4% and 74.2% with R0 status versus 56.6% and 26.3% with R1 status. The 5-year overall survival and local control rates were 46.2% and 70.7% with surgery alone, 78.1% and 43.2% with surgery and adjuvant CRT, and 25.0% and 80.0% with primary CRT.
  
  
  CONCLUSIONS
  Surgery is integral to the management of external auditory canal cancer, whereas CRT is necessary as an adjuvant or primary treatment, depending on tumor stage.
  
  
  METHODS
  4.
authors.affiliation: Department of Otorhinolaryngology.
authors.forename: Friedrich
authors.identifier: http://orcid.org/0000-0001-7066-4994
authors.initials: F
authors.lastname: Ihler
authors.affiliation: Department of Otorhinolaryngology, University Hospital Muenster (m.k., d.w.), Muenster.
authors.forename: Mario
authors.initials: M
authors.lastname: Koopmann
authors.affiliation: Department of Otorhinolaryngology.
authors.forename: Bernhard G
authors.initials: BG
authors.lastname: Weiss
authors.affiliation: Department of Radiotherapy and Radiooncology, University Medical Center Göttingen, Göttingen.
authors.forename: Leif Hendrik
authors.initials: LH
authors.lastname: Dröge
authors.affiliation: Department of Otorhinolaryngology (m.d.).
authors.forename: Martin
authors.initials: M
authors.lastname: Durisin
authors.affiliation: Department of Radiotherapy and Radiooncology, Hannover Medical School, Hannover, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Christiansen
authors.affiliation: Department of Otorhinolaryngology, University Hospital Muenster (m.k., d.w.), Muenster.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weiß
authors.affiliation: Department of Otorhinolaryngology.
authors.forename: Martin
authors.initials: M
authors.lastname: Canis
authors.affiliation: Department of Radiotherapy and Radiooncology, University Medical Center Göttingen, Göttingen.
authors.forename: Hendrik A
authors.initials: HA
authors.lastname: Wolff
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D000368:Aged; D001706:Biopsy; D004424:Ear Canal; D004428:Ear Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D013506:Otologic Surgical Procedures / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Carcinoma; chemoradiotherapy; external auditory canal; retrospective multicenter study; surgical margin; survival rate