A Direct Comparison of Visual Inspection, Curettage, and Epiluminescence Microscopy in Determining Tumor Extent Before the Initial Margins Are Determined for Mohs Micrographic Surgery

Guardiano, Robert A; Grande, Donald J.

doi:10.1111/j.1524-4725.2010.01616.x

Cited by 15 publications

(22 citation statements)

References 6 publications

(9 reference statements)

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“…3,4,5,6 In view of the increased incidence of skin cancer in the last decades, there is a need for improvement of the Mohs technique so as to optimize its efficacy. 3,4,7,8,9,10,11 …”

Section: Introductionmentioning

confidence: 99%

Utility of dermoscopy for demarcation of surgical margins in Mohs micrographic surgery

Suzuki¹,

Serafini

Sato

2014

An. Bras. Dermatol.

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BACKGROUNDSkin cancer is the most common malignancy and can be treated in various ways. One treatment modality is Mohs micrographic surgery. Due to the increasing incidence of skin cancer in the last decades, there is a need for improvement of the Mohs technique to optimize its effectiveness. OBJECTIVEThe aim of this study was to evaluate the use of dermoscopy to guide demarcation of Mohs micrographic surgery margins and ascertain whether this method can reduce operative time and, therefore, reduce surgical morbidity and cost. METHODS AND MATERIALSThe sample comprised 44 patients who underwent Mohs micrographic surgery, allocated into two groups: the control group and the intervention group. In the latter, surgical margins were guided by dermoscopy. RESULTSThere were no statistically significant differences between the two groups by chi-square analysis (p = 0.399). CONCLUSIONAlthough outcomes were similar in the two groups, demonstrating that dermoscopy does not help in the demarcation of surgical margins for Mohs micrographic surgery, the study provides a practical proposal for improvement of the Mohs technique.

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“…3,4,5,6 In view of the increased incidence of skin cancer in the last decades, there is a need for improvement of the Mohs technique so as to optimize its efficacy. 3,4,7,8,9,10,11 …”

Section: Introductionmentioning

confidence: 99%

Utility of dermoscopy for demarcation of surgical margins in Mohs micrographic surgery

Suzuki¹,

Serafini

Sato

2014

An. Bras. Dermatol.

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“…Dermoscopy, for example, is an established clinical aid [7] that offers some improvement in defining a preoperative border in SSE that otherwise relies wholly on effective visual assessment [8]. However, pre-surgical assessment with dermoscopy has not been shown to lead to any reduction in the total number of MMS stages required for complete excision [9]. Similarly, high-resolution ultrasound generally provides insufficient contrast in subtle areas of tumor extension to be of significant clinical value in preoperative mapping of BCC [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Automated registration of optical coherence tomography and dermoscopy in the assessment of sub-clinical spread in basal cell carcinoma

Coleman¹,

Penney²,

Richardson³

et al. 2014

Computer Aided Surgery

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Optical coherence tomography (OCT) has been shown to be of clinical value in imaging basal cell carcinoma (BCC). A novel dual OCT-video imaging system, providing automated registration of OCT and dermoscopy, has been developed to assess the potential of OCT in measuring the degree of sub-clinical spread of BCC. Seventeen patients selected for Mohs micrographic surgery (MMS) for BCC were recruited to the study. The extent of BCC infiltration beyond a segment of the clinically assessed pre-surgical border was evaluated using OCT. Sufficiently accurate (<0.5 mm) registration of OCT and dermoscopy images was achieved in 9 patients. The location of the OCT-assessed BCC border was also compared with that of the final surgical defect. Infiltration of BCC across the clinical border ranged from 0 mm to >2.5 mm. In addition, the OCT border lay between 0.5 mm and 2.0 mm inside the final MMS defect in those cases where this could be assessed. In one case, where the final MMS defect was over 17 mm from the clinical border, OCT showed >2.5 mm infiltration across the clinical border at the FOV limit. These results provide evidence that OCT allows more accurate assessment of sub-clinical spread of BCC than clinical observation alone. Such a capability may have clinical value in reducing the number of surgical stages in MMS for BCC. There may also be a role for OCT in aiding the selection of patients most suitable for MMS.

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“…[6] At the present time there is no standard way for determining lesion border before MMS. [2] Obviously if the lesion margin is determined more precisely before surgery, total resection stage numbers will be reduced and if among the methods of determining tumor margin, a method could determine the margin better, it should be used for patient.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, 54 patients had been divided into three groups that the resection numbers averages in groups had no significant difference. [2]…”

Section: Discussionmentioning

confidence: 99%

“…[1] Some authors prefer this method for determining the lesion limitations before MMS. [2] In a study which was conducted on 166 patients with BCC on head or neck in 2004, conducted by Huang et al ., patients were divided to curettage and non-curettage groups randomly and it was revealed that less resection stages are needed in curettage group. [9]…”

Section: Discussionmentioning

confidence: 99%

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Comparison between examination with naked eye, curretage and dermoscopy in determining tumor extension before Mohs micrographic surgery

Asilian

Momeni

2013

Adv Biomed Res

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Mohs micrographic surgery (MMS) is a technique for the treatment of cutaneous malignancies. Subtle determination of tumor margin would end to fewer stages of surgery. Our aim was to compare these three ways for determining tumor extension before initiation of MMS, examination with the naked eye, dermoscopy and curettage. Sixty patients who had basal cell carcinoma (BCC) in head and neck area were randomized in three groups (curettage, dermoscopy and examination with the naked eye). Each group encompassed twenty patients. The total number of resection stages in MMS was recorded for each patient. Demographic data of the patients and the total number of resection stages in MMS were statistically analyzed. Based on analysis of variance (ANOVA) test results, there was no significant difference for total number of stages in statistical point of view between three groups (P value = 0.1). In this research, the Pearson correlation coefficient showed that there is a direct relation between the age and resection stages (r = 0.19, P value = 0.04). The Chi-square test showed no differences between three groups in age, residence and radiotherapy history.

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A Direct Comparison of Visual Inspection, Curettage, and Epiluminescence Microscopy in Determining Tumor Extent Before the Initial Margins Are Determined for Mohs Micrographic Surgery

Cited by 15 publications

References 6 publications

Utility of dermoscopy for demarcation of surgical margins in Mohs micrographic surgery

Utility of dermoscopy for demarcation of surgical margins in Mohs micrographic surgery

Automated registration of optical coherence tomography and dermoscopy in the assessment of sub-clinical spread in basal cell carcinoma

Comparison between examination with naked eye, curretage and dermoscopy in determining tumor extension before Mohs micrographic surgery

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