Xue-Lian Xu,1 Hao Cheng,1,2 Xin-Meng Wu,1 Jin-Hong Xu3 

1Department of Radiotherapy Oncology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453100, People’s Republic of China; 2Department of Radiotherapy Oncology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, 450000, People’s Republic of China; 3Department of Otolaryngology, AnYang District Hospital, Anyang, Henan, 455000, People’s Republic of China

Correspondence: Hao Cheng, Email cheng198861hao@163.com

Background: External auditory canal carcinoma (EACC) is a rare malignant tumor. This study aimed to investigate the influence of the comprehensive index of nutrition- Naples prognostic score (NPS) on the prognosis of EACC patients with surgical resection.
Methods: A total of 73 EACC patients with surgical resection were selected from two tertiary medical institutions, and were diagnosed between Sep 2008 and Aug 2019. The univariate and multivariate Cox regression analyses were used to identify the independent prognostic factors for disease-free survival (DFS) and overall survival (OS) for postoperative EACC patients. The prognosis for postoperative EACC patients with varying NPS were displayed by Kaplan-Meier plots.
Results: The 3- and 5-year survival rate for EACC patients with surgical resection were 72.6%, 32.9% for DFS, and 76.7%, 52.1% for OS, respectively. The multivariate Cox regression analysis revealed that advanced Pittsburgh stage, perineural invasion, vascular invasion, and higher NPS were identified as independent prognostic factors for DFS. Additionally, advanced Pittsburgh stage, vascular invasion, an ACCI score of 6 or higher, and higher NPS were found to be independent predictors for OS.
Conclusion: NPS serves as a crucial predictor of postoperative outcomes in patients with EACC, with higher levels indicating poorer disease-free and overall survival. Additionally, factors such as Pittsburgh stage, perineural and vascular invasion, and ACCI are also significant prognostic indicators.

Keywords: external auditory canal carcinoma, Naples prognostic score, prognosis, disease-free survival, overall survival