Melanoma of the ear: treatment and survival probabilities based on 199 patients.

Published

Journal Article

BACKGROUND: In 2005, it is now estimated that one in 62 Americans have a lifetime risk of developing invasive melanoma. Melanoma of the ear accounts for 1% of all cases of melanoma and 14.5% of all head and neck melanomas. With this increase in incidence, plastic surgeons will likely have to treat and manage more of these patients in the future. METHODS: A retrospective chart review was performed on 199 patients diagnosed with primary melanoma of the ear. Specimens were reviewed by same center dermatopathologists (Duke University Medical Center, Durham, NC) for standardization of histologic criteria in all but 10 patients. Surgical treatment and outcomes were reviewed and survival rates based on thickness and stage were calculated. Metastases information, anatomic location on the ear, and histologic subtype were recorded and analyzed. RESULTS: The median length of follow up was 3.3 years with a range of 0.4 to 24.9 years. Eighty-six patients were known to be dead at the last known follow-up date. The median survival time among these patients was 7.9 years. The most common histologic classification of the lesions were superficial spreading type (45.2%) and were most likely to be localized to the anterior helix (49.3%). One hundred sixty-one of 199 (80.9%) patients underwent wide local excision with local recurrence rate of 10.6%. Overall, 43.2% of patients developed a local recurrence or metastatic spread. Ulceration, thickness, and stage all negatively affected survival. CONCLUSIONS: This is the largest review of primary ear melanoma cases reported to date. Survival probabilities at 2, 5, and 10 years for melanoma of the ear based on thickness and stage are presented. Ulceration adversely affected survival probability (P < 0.003). Lesion excision with confirmed negative margins on permanent section pathology should be the goal of initial surgical therapy, and there is no apparent role for elective lymph node dissection in treatment of melanoma of the ear.

Full Text

Duke Authors

Cited Authors

  • Ravin, AG; Pickett, N; Johnson, JL; Fisher, SR; Levin, LS; Seigler, HF

Published Date

  • July 2006

Published In

Volume / Issue

  • 57 / 1

Start / End Page

  • 70 - 76

PubMed ID

  • 16799312

Pubmed Central ID

  • 16799312

International Standard Serial Number (ISSN)

  • 0148-7043

Digital Object Identifier (DOI)

  • 10.1097/01.sap.0000208960.96944.c9

Language

  • eng

Conference Location

  • United States