Carcinoma of the external and middle ear is a very
rare disease. Despite the various treatment modalities available, its prognosis is still poor. We aimed to analyze the treatment modalities, outcomes, and validity of surgical approaches, especially in advanced
tumors in the ear. Twenty-five patients with
carcinoma of the external and middle ear were retrospectively analyzed. The modified Pittsburgh staging system was used for staging of the patients. Overall and disease-free survival was estimated using of Kaplan-Meier method. In our cohort of 25 patients, the majority (76%) had
tumor located in external auditory meatus. The most common histologic subtype was
squamous cell carcinoma (80%). More than half of patients (56%) had
tumor stage IV. In the stage IV group, five patients underwent subtotal temporal bone resection and ipsilateral
neck dissection. Seven patients underwent definitive
radiotherapy. The remaining two patients underwent palliative
chemotherapy. The 2-year overall and disease-free survival for patients with
tumor stage IV was 67.7% and 57.8%, respectively. In patients with
tumor stage IV, the 2-year overall survival for patients who underwent surgery was 80.0% versus 53.6% for those who underwent
radiotherapy (P = 0.16). The 2-year disease-free survival for patients who underwent surgery was 80.0% versus 28.6% for those who underwent
radiotherapy (P = 0.15). In the present study, the outcome of patients who received surgical treatment tended to be better than that of patients who received
radiation therapy. Our results suggest that en bloc resection could be the first choice even in the advanced disease stage.