Melanoma of the ear: prognostic factors and surgical strategies.

摘要: Background The ear's specific anatomical and lymphatic characteristics impose special requirements on the treatment of melanoma ear. Objectives aim this prospective study was to define prognostic factors for ear evaluate surgical strategies excision margins, histological evaluation sentinel lymph node biopsy (SLNB) in order achieve better cosmetic functional results. Patients methods One-hundred sixty-one patients with stage I/II external were treated Department Dermatology, University Tuebingen, from March 1976 2004 (median follow-up 62 months). Malignant represented 3% cutaneous melanomas 20% head neck recorded Melanoma Registry Dermatology at Tuebingen. Twenty 42 lentigo maligna (LMM) underwent conventional evaluation, 22 complete three-dimensional histology margins (3D histology) a paraffin-technique, i.e. micrographic surgery. SLNB performed 28 thicker than 1.0 mm. Clinical, risk evaluated by univariate multivariate analysis. Results median thickness tumours present 1.08 mm (mean 1.51 mm; range 0.18-8.50 mm), 11.0 12.61 2.0-31.0 mm). 3-year disease-specific survival rate 98%, recurrence-free 83%. Tumour invasion level only significant survival. thickness, location tumour extent independently LMMs removed surgically accompanying 3D those examined 0.93 vs. 0.83 use surgery histology, surgery, made it possible reduce 5 10 mm) without an increased recurrence. Two 29 SLNBs positive (6.9%). There six preregional recurrences after negative one SLNB. None who died melanoma-related causes during observation period. Conclusions This is largest series reported so far. overall depended Clark invasion. Local recurrence more frequent smaller but did not influence Smaller under 3D-histological control carry local Our results do permit conclusions regarding impact