{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:02:10Z","timestamp":1769126530721,"version":"3.49.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and purpose<\/jats:title>\n            <jats:p>To compare overall survival (OS) differences across 11 different staging classifications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Patient data were retrospectively collected. OS curves were estimated by Kaplan-Meier method. Hazard ratios (HR) were calculated by Cox regression. Concordance between HR of each system was evaluated by C-index. Absolute net reclassification improvement (NRI) was performed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Thirty-five patients fitted study criteria with median follow-up of 27.3 months. 80% were diagnosed with squamous cell carcinoma. 14.3% had ECOG\u2009&gt;\u20091. Eighteen patients underwent surgery, while 31 patients received radiotherapy. For AJCC 8th edition cutaneous carcinoma of the head and neck, 3-year OS of stage 1\u20133 and 4 was 26.7% (median OS of 0.8 years) and 64.1% (median OS of 4.3 years) (HR 0.33; 95%CI 0.09\u20131.2). 3-year OS of T1-3 and T4 in modified Pittsburgh classification were 65% and 55.4% with median OS of not reached and 3.1 years (HR 1.86; 95%CI 0.66\u20135.23). Regarding Kinney system, patients with stage 1\u20132 and 3 had 3-year OS of 67.1% and 45.5%, while median OS was 4.7 years and 1 year (HR 1.94; 95%CI 0.75\u20134.97). C-indices were 0.577, 0.523 and 0.569. NRI comparing Kinney with modified Pittsburgh classifications was 2.86%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Kinney\u2019s may offer improved prognostic accuracy compared to other classifications.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-025-09489-4","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T16:09:14Z","timestamp":1748880554000},"page":"4765-4771","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of 11 staging classifications in carcinoma of the external auditory canal"],"prefix":"10.1007","volume":"282","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3924-1210","authenticated-orcid":false,"given":"Aniwat","family":"Berpan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"issue":"4","key":"9489_CR1","first-page":"582","volume":"21","author":"SA Moody","year":"2000","unstructured":"Moody SA, Hirsch BE, Myers EN (2000) Squamous cell carcinoma of the external auditory Canal: an evaluation of a staging system. Am J Otol 21(4):582\u2013588","journal-title":"Am J Otol"},{"issue":"9 Pt 1","key":"9489_CR2","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1177\/000348949009900909","volume":"99","author":"M Arriaga","year":"1990","unstructured":"Arriaga M, Curtin H, Takahashi H et al (1990) Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings. Ann Otol Rhinol Laryngol 99(9 Pt 1):714\u2013721","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"9489_CR3","first-page":"357Y61","volume":"46","author":"J Lavieille","year":"1997","unstructured":"Lavieille J, Reyt E, Boulat E et al (1997) Cancers du conduit auditif externe et de L\u2019oreille Moyenne: indications chirurgicales et nouvelles classification. JFORL 46:357Y61","journal-title":"JFORL"},{"issue":"11","key":"9489_CR4","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1001\/archotol.1980.00790350017006","volume":"106","author":"WJ Goodwin","year":"1980","unstructured":"Goodwin WJ, Jesse RH (1980) Malignant neoplasms of the external auditory Canal and Temporal bone. Arch Otolaryngol 106(11):675\u2013679","journal-title":"Arch Otolaryngol"},{"issue":"2","key":"9489_CR5","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1017\/S0022215121000323","volume":"135","author":"M George","year":"2021","unstructured":"George M, Borsotti F, Gereige R et al (2021) A systematic review of the primary squamous cell carcinoma of the external auditory Canal: survival outcome based on T-staging and proposal of a new classification. J Laryngol Otol 135(2):96\u2013103","journal-title":"J Laryngol Otol"},{"issue":"9","key":"9489_CR6","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1097\/MAO.0b013e3181f7ab85","volume":"31","author":"TS Higgins","year":"2010","unstructured":"Higgins TS, Antonio SA (2010) The role of facial palsy in staging squamous cell carcinoma of the Temporal bone and external auditory Canal: a comparative survival analysis. Otol Neurotol 31(9):1473\u20131479","journal-title":"Otol Neurotol"},{"issue":"9","key":"9489_CR7","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1002\/hed.21883","volume":"34","author":"LG Morris","year":"2012","unstructured":"Morris LG, Mehra S, Shah JP et al (2012) Predictors of survival and recurrence after Temporal bone resection for cancer. Head Neck 34(9):1231\u20131239","journal-title":"Head Neck"},{"issue":"8","key":"9489_CR8","doi-asserted-by":"publisher","first-page":"1174","DOI":"10.1097\/MAO.0000000000001152","volume":"37","author":"S Morita","year":"2016","unstructured":"Morita S, Homma A, Nakamaru Y et al (2016) The outcomes of surgery and chemoradiotherapy for Temporal bone Cancer. Otol Neurotol 37(8):1174\u20131182","journal-title":"Otol Neurotol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09489-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-025-09489-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09489-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T20:04:53Z","timestamp":1757534693000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-025-09489-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,2]]},"references-count":8,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["9489"],"URL":"https:\/\/doi.org\/10.1007\/s00405-025-09489-4","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,2]]},"assertion":[{"value":"13 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the hospital ethical review board for retrospective analysis and the requirement of informed consent was waived, and was performed in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}