Carcinoma of the external ear

An analysis of 246 operated patients with 260 carcinomas of the external ears from the periods 1949-57 and 1962-67 is presented. Carcinoma of the external ear occurs in Denmark with a frequency of 1.2 cases per 100 000 inhabitants and constitutes approximately 6% of all skin cancers. In the present material 67% of the tumours were squamous-cell carcinomas and 30% were basal-cell carcinomas. These forms of tumours were most frequent in elderly men who have had outdoor employment. Half of these tumours were sited on the helix and lobe, while one quarter, respectively, were sited medially and laterally. 15% of the squamous-cell carcinomas recurred, 3% of the these with metastases of the regional lymph nodes. Of the basal-cell carcinomas 18% recurred but with no metastases of the regional lymph nodes. The frequency of recurrence did not depend on the site of the tumour on the ear, but it did increase with increasing tumour size. The 5-year survival rate without recurrence was 56% +/- 4% for the squamous-cell carcinomas, and for the basal-cell carcinomas 59% +/- 6.5%. It is concluded that surgical treatment is best suited for these tumours, and the minimum excision distance for basal-cell carcinomas of less than 3 cm in size should be 8 mm, while for squamous-cell carcinomas of the same size the distance should be 10 mm. For both forms of tumour where the greatest extent is more than 3 cm the excision distance should be at least 15 mm.