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Background <p>Melanoma of the ear accounts for approximately 1% of cutaneous melanomas. Management recommendations are based on small retrospective series and case reports. Resection of melanoma of the ear requires a delicate balance between disease clearance, preservation of function, and aesthetics. The role of cartilage resection in the wide excision of melanoma of the ear remains unclear. We aimed to compare outcomes in patients having wide excision of ear melanoma who had cartilage resected with those who had a cartilage-sparing approach.</p> Methods <p>Data were obtained from the Melanoma Institute Australia (MIA) prospectively maintained database. All patients diagnosed with invasive melanoma involving the ear between 1990 and 2022 were included. Data analysis was performed to assess the association between cartilage resection and recurrence-free survival (RFS), melanoma-specific survival (MSS), and overall survival (OS).</p> Results <p>Overall, 411 patients were included in the study, of whom 330 (80%) had cartilage resected and 81 (20%) had a cartilage-sparing resection. The cartilage resection group had a higher mean Breslow thickness (1.9&#xa0;vs. 1.4&#xa0;mm; <i>p</i>&#xa0;=&#xa0;0.0002), whereas the cartilage-sparing group had a higher proportion of stage IA disease (60.5 vs. 39.7%; <i>p</i>&#xa0;=&#xa0;0.041). Five (1.2%) patients had melanoma invading into perichondrium but not deeper. Cartilage resection had no impact on RFS {hazard ratio [HR] 0.82 (0.52–1.29); <i>p</i>&#xa0;=&#xa0;0.39} or MSS (HR 0.89 (0.30–2.62); <i>p</i>&#xa0;=&#xa0;0.83).</p> Conclusion <p>The decision to resect cartilage as part of the wide excision of invasive ear melanoma should be tailored to the needs of the individual patient, however a cartilage-sparing approach does not appear to compromise MSS outcomes, particularly in early-stage disease.</p>

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Cartilage Resection in the Surgical Management of Ear Melanoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月28日

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  • Elan Novis,
  • Joyce Tan,
  • Danielle Vignati,
  • Terence Wong,
  • Robert V. Rawson,
  • Jonathan R. Stretch,
  • Serigne N. Lo,
  • Thomas E. Pennington,
  • Sydney Ch’ng,
  • Kerwin F. Shannon,
  • Andrew J. Spillane,
  • Omgo E. Nieweg,
  • John F. Thompson,
  • Michael Rtshiladze,
  • Richard A. Scolyer,
  • Robyn P. M. Saw

摘要

Background

Melanoma of the ear accounts for approximately 1% of cutaneous melanomas. Management recommendations are based on small retrospective series and case reports. Resection of melanoma of the ear requires a delicate balance between disease clearance, preservation of function, and aesthetics. The role of cartilage resection in the wide excision of melanoma of the ear remains unclear. We aimed to compare outcomes in patients having wide excision of ear melanoma who had cartilage resected with those who had a cartilage-sparing approach.

Methods

Data were obtained from the Melanoma Institute Australia (MIA) prospectively maintained database. All patients diagnosed with invasive melanoma involving the ear between 1990 and 2022 were included. Data analysis was performed to assess the association between cartilage resection and recurrence-free survival (RFS), melanoma-specific survival (MSS), and overall survival (OS).

Results

Overall, 411 patients were included in the study, of whom 330 (80%) had cartilage resected and 81 (20%) had a cartilage-sparing resection. The cartilage resection group had a higher mean Breslow thickness (1.9 vs. 1.4 mm; p = 0.0002), whereas the cartilage-sparing group had a higher proportion of stage IA disease (60.5 vs. 39.7%; p = 0.041). Five (1.2%) patients had melanoma invading into perichondrium but not deeper. Cartilage resection had no impact on RFS {hazard ratio [HR] 0.82 (0.52–1.29); p = 0.39} or MSS (HR 0.89 (0.30–2.62); p = 0.83).

Conclusion

The decision to resect cartilage as part of the wide excision of invasive ear melanoma should be tailored to the needs of the individual patient, however a cartilage-sparing approach does not appear to compromise MSS outcomes, particularly in early-stage disease.