Abstract
Preserving auricular cartilage can have satisfactory aesthetic outcomes and retain the functional integrity of the ear. Limited research exists on the oncological sequelae of preserving or removing cartilage when excising auricular melanoma. This systematic review compares outcomes between cartilage-sparing and cartilage-removing techniques in the treatment of auricular melanoma. A systematic literature search of PubMed, Scopus, and MEDLINE acquired 23 studies; following independent screening using a PICOT framework-guided inclusion and exclusion criteria and subsequent quality assessment, 6 retrospective studies were included in the final review. The literature suggests that there is a difference in recurrence rates and disease-specific mortality between cartilage-sparing and cartilage-removing excisions. Recurrence and disease-specific mortality appeared to be higher in studies that excised cartilage. However, these findings are inconclusive and undermined by several critical limitations. The explanation, direction, and magnitude of this difference remain unclear, and further long-term randomised control trials are required to confirm the differences in oncological outcome between cartilage-sparing and cartilage-removing excisions of auricular melanoma.