The importance of ulceration of cutaneous melanoma of the head and neck: A comparison of ear (pinna) and nonear sites

Abstract

Objectives/Hypothesis: To compare clinicopathologic and prognostic factors associated with ear melanomas and nonear melanomas of the head and neck (H&N). Study Design: Post hoc analysis of the database from a multi-institutional, prospective, randomized study. Methods: Clinicopathologic factors were assessed and correlated with survival and recurrence. Univariate and multivariate analysis of prognostic factors affecting disease-free survival (DFS) and overall survival (OS) were performed. Results: Of 405 patients with H&N melanomas ≥1.0 mm Breslow thickness, 59 patients had melanomas of the ear. Most were Caucasian (96.6%) males (79.7%) with a mean age of 52 years. The mean Breslow thickness was 2.5 mm; 34.5% had signs of ulceration. Sentinel lymph node (SLN) positivity was seen in 7.1%. The incidence of locoregional and distant recurrence were similar. OS for ear melanoma was significantly impacted by ulceration status (P =.013), whereas both ulceration and SLN positivity predicted survival in nonear melanoma (P