Antonio Mazzoni1,2, Elisabetta Zanoletti1, Gino Marioni1, Alessandro Martini1. 1. a Department of Neurosciences DNS, Otolaryngology Section , Padova University , Padova , Italy ; 2. b Formerly Neurosciences Department, Otolaryngology , Ospedali Riuniti , Bergamo , Italy.
Abstract
CONCLUSIONS: En bloc resection should always be primarily considered in ear carcinoma, also in advanced tumors growing beyond the walls of the external auditory canal, because it achieves a full specimen for histopathological evaluation and allows a correlation between clinical, pathological features, and outcomes. OBJECTIVE AND METHODS: Dismal outcome of surgical and radiotherapic therapies for advanced ear carcinoma required a critical discussion of the oncological principles of treatment. Our analysis involved preliminarily a detailed description of surgical technique including the contribution of modern skull base microsurgery. RESULTS: Evident limits in diagnostic protocols, surgical treatment and outcome evaluation modalities pointed to the need of a new approach towards an accurate definition of pre-operative tumor location, size, and behavior. En bloc resection achieved a specimen for a final pathological evaluation and an adjunctive piecemeal excision was necessary only whenever resection was not felt falling in safe, tumor-free tissue. Chemotherapy and radiotherapy should be considered in selected cases for adjuvant treatment.
CONCLUSIONS: En bloc resection should always be primarily considered in ear carcinoma, also in advanced tumors growing beyond the walls of the external auditory canal, because it achieves a full specimen for histopathological evaluation and allows a correlation between clinical, pathological features, and outcomes. OBJECTIVE AND METHODS: Dismal outcome of surgical and radiotherapic therapies for advanced ear carcinoma required a critical discussion of the oncological principles of treatment. Our analysis involved preliminarily a detailed description of surgical technique including the contribution of modern skull base microsurgery. RESULTS: Evident limits in diagnostic protocols, surgical treatment and outcome evaluation modalities pointed to the need of a new approach towards an accurate definition of pre-operative tumor location, size, and behavior. En bloc resection achieved a specimen for a final pathological evaluation and an adjunctive piecemeal excision was necessary only whenever resection was not felt falling in safe, tumor-free tissue. Chemotherapy and radiotherapy should be considered in selected cases for adjuvant treatment.
Authors: Conrad F Smit; Niels de Boer; Birgit I Lissenberg-Witte; Paul Merkus; Erik F Hensen; C René Leemans Journal: Acta Otorhinolaryngol Ital Date: 2021-08 Impact factor: 2.124