The study subjects comprised 56 patients with squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear. The mean age was 65 years (ranging between 41 and 93 years). There were 30 males and 26 females. The trial centers were Kyushu University Hospital from Jan '98 to Mar '06 and Fukuoka University Hospital from April '06 to Mar '11. Subjects who were followed up for longer than 12 months, with the exception of those who died from disease, were included in the study. The mean follow-up period was 37 months. The numbers of patients at T1N0, T1N1, T2N0, T2N1, T3N0, T3N1, T4N0 and T4N1 were 1, 0, 12, 3, 7, 2, 20 and 11, respectively. Twenty-nine percent of the patients (n = 16) had lymph node metastasis. There was one case of Ml at T2N1M1. Treatment strategy was determined by the extent of tumor, which was evaluated with both CT and MRI before any treatment. The 5-year-survival rates of T3 and T4 patients were 89% and 52%, respectively. However, the 5-year-survival rate of T1 and T2 decreased to 68% and was lower than that of T3. Four T1 and T2 patients of died of disease at follow-up periods of 16, 18, 18 and 37 months. Markers of epithelial-mesenchymal transition (EMT) in SCC tumor cells were examined in 7 out of 16 cases and 3 cases out of 4 who died of disease were included in the study. Staining for vimentin was positive and laminin was diffusely stained in all cases.
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