The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital

Abstract

OBJECTIVE:Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal.METHODS:The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications.RESULTS:Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications.CONCLUSION:Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating “skip areas” and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.

Correlation Between Demographic and Tumor Characteristics in Non-melanoma Skin Cancers Submitted to Mohs Micrographic Surgery

“…Thompson et al reported that sex had a significant impact on mental and physical healthcare, indicating that women visited their doctors much more frequently than men. Thus, the predominance of women in our study is compatible with the attendance to healthcare services reported by other authors (10)(11)(12).…”

Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region

“…The factors that cause treatment failure through SEPMC include main tumors with skip areas, perineural invasion of some high-risk BCCs, and inconsistency between the surgeon and the pathologist in marking the tissue samples for pathologic assessment. 11 , 12 …”

“…BCCs with high-risk pathologic features – including morphoeic, infiltrative, and micronodular types – are more likely to develop skip area dissemination and perineural invasion; therefore, recurrence is possible even with MMS. 2 , 11 , 12 , 13 , 16 , 17…”

Prevalence of wound complications following Mohs micrographic surgery (MMS): a cross-sectional study of 1000 patients undergoing MMS and wound repair in a UK teaching hospital

“…MMS is widely considered to have an excellent safety profile, with postoperative complication rates reported in the literature of 0.7%–6% 4–9 . The majority of studies have been conducted in the USA and have been incorporated into Supplementary Table S1.…”

“…2,3 MMS is widely considered to have an excellent safety profile, with postoperative complication rates reported in the literature of 0.7%-6%. [4][5][6][7][8][9] The majority of studies have been conducted in the USA and have been incorporated into Supplementary Table S1. Inherent differences in both population demographics and healthcare provision make it difficult to translate findings from studies using existing healthcare data from one country to another.…”