Mohs Micrographic Surgery for the Treatment of External Ear Melanoma: an Outcome Study

BACKGROUND The external ear is composed of thin skin overlying cartilage making melanoma on the external ear difficult to resect while preserving the intricate anatomy. Although surgeons have achieved robust clinical outcomes for nonmelanoma and most recently melanoma skin cancers with Mohs micrographic surgery (MMS), there is still not enough evidence on the MMS application for external ear melanoma treatment. OBJECTIVE The authors examined survival outcomes in patients treated with MMS, narrow margin excision (NME), and wide margin excision (WME) for melanoma on the external ear. METHODS Data from the NCI SEER program was retrospectively analyzed. Patients who received surgical treatment on the external ear and had microscopically confirmed diagnosis of cutaneous melanoma were included in the study. The effect of different surgery types: MMS, NME, and WME, on melanoma survival was evaluated. RESULTS A total of 8,212 melanoma cases of the external ear performed during the years 2000 to 2015 were considered for analysis. There were no significant differences in survival comparing NME and WME with MMS. CONCLUSION Mohs micrographic surgery is at least equivalent to WME for the treatment of melanoma of the external ear.