Chemosurgery: My 15 Years of Experience

Abstract

WHEN I BEGAN TO PRACTICE CHEMOSURGERY nearly sixteen years ago, only one out of every five dermatologists and possibly one out of every twenty physicians of the rest of the medical community were aware that that technique of managing cutaneous cancers existed, even though Dr. Frederic Mohs had developed it 25 years earlier. At the time, fewer than 20 physicians, mostly dermatologists and a few general surgeons, were practicing chemosurgery , a mere handful compared to the number practicing it today. Nowadays more than one hundred physicians skilled in the method are members of the American College of Chemosurgery, and chemosurgery is almost a household word in medical circles. The entire dermatologic world and most of the surgical community recognize it as the most effective treatment for basal-and squamous-cell carcinomas.Thirteen years ago I introduced the first one-year comprehensive training program in chemosurgery , an expansion upon the one-and two-week programs that Dr. Mohs had established in Madison, Wisconsin. The program begun at the New York University Medical Center was the first in which qualified physicians could receive extensive training in chemosurgery and general dermatologic surgery. Upon completion of the program, those trained in chemosurgery (17 to date) have since started practices at several leading medical centers throughout the world, and these have multiplied many times the value and availability of this novel and highly effective technique. Eventually, word of it reached physicians of all specialties and has resulted in Dr.

Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study

“…It is closer to that obtained with Mohs surgery, which is often below 2% (Tromovitch and Stegman, 1978;Robins, 1981;Robins et al, 1985;Roenigk et al, 1986;Rowe et al, 1989;Lawrence, 1993;Hruza, 1994). In contrast to radiotherapy, a histological appraisal of the efficiency of the treatment is possible with surgery.…”

Regional Spread of Auricular and Periauricular Cutaneous Malignancies

“…Thus it is difficult to determine the exact incidence of local recurrence or regional disease. In addition, previous studies have shown that preauricular lesions treated with Mohs surgery have a higher tendency to recur when compared with lesions in other periauricular sites 14,23,24 . Eight of our patients had Mohs surgery as the initial therapy.…”

Mohs math – where the error hides

“…Persistent tumor may be related to "difficulties of anatomic site[10], tumor size and histological subtype[11], as well as observer error in histological interpretation and potential tumor multifocality[12]" [13]. There are also many processing errors that may occur including inaccurate mapping, tissue staining, and tissue preparation for sectioning.…”