||中川 尚志, 末田 尚之, 鍋島一樹, Surgical management of T1 and T2 lesions with outcomes. / Nakagawa T, Sueta T, Nabeshima M．Cholesteatoma and Ear Surgery –an update．Takahashi H edn. (2013, pp. 133-136), Kugler Publications, Amsterdam, 2013.09, We treated 56 patients with squamous cell carcinoma of external auditory canal (EAC) and middle ear. Settings were Kyushu University Hospital from January 1998 to March 2006 and Fukuoka University Hospital from April 2006 to March 2011. Mean age was 65 years (ranged between 41 and 93 years). There were 31 male and 26 female patients. Cases of a follow-up period of more than 12 months were included in the study. Patients who died of the disease were not included. Mean follow-up period was 37 months. Numbers of cases: T1N0 = one; T1N1 = none; T2N0 = 12; T2N1 = three; T3N0 = seven; T3N1 = two; T4N0 = 20; T4N1 = 11. Twenty-nine percent (n = 16) had lymph-node metastasis. The five-year survival rate of T3 and T4 was 89% and 52%, respectively. However, the five-year survival rate of T1 and T2 decreased to 68% and was lower than that of T3. Although treatment strategy was maintained during 12 years, the number of cases of T1 and T2 was roughly three times that of the previous report. Fig. 3 shows details of T1 and T2 cases. Four patients died of the disease in the follow-up period of 16, 18, 18 and 37 months. Markers of epithelial-mesenchymal transition (EMT) in the SCC tumor cells were examined in seven out of 16 cases. Three out of four patients who died of the disease were included in the study. Vimentin was positive and laminin was diffusely stained in all cases..