Cost-effectiveness of Mohs Micrographic Surgery vs Surgical Excision for Basal Cell Carcinoma of the Face

Otley, Clark C.

doi:10.1001/archderm.142.9.1235-a

Cited by 10 publications

(8 citation statements)

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“…29 Cure rates for periocular BCC treated with MMS in a study of 631 cases was 98.1% for primary tumors and 93.6% for recurrent tumors, with previously treated medial canthal lesions (especially those initially treated with irradiation) having the highest risk of recurrence after MMS. 34,35 Critical reviews of the literature support that MMS is a more cost-effective treatment for NMSC than standard excision. 31 Some have argued against the cost effectiveness and practicality of MMS for BCC of the face, 32 including periocular tumors, 33 although this data has been challenged.…”

Section: Basal Cell Carcinomamentioning

confidence: 99%

Periocular Cutaneous Malignancies: A Review of the Literature

Slutsky

Jones

2012

Dermatologic Surgery

105

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Timely diagnosis and management of periocular malignancies is essential because of their proximity to and potential to invade vital structures such as the orbit, sinuses, and brain. Surgical excision remains the standard of care for the majority of periorbital malignancies, but given the sensitive anatomic location, tissue-sparing techniques with margin control such as Mohs micrographic surgery are the preferred method for most nonmelanoma skin cancers. Depending on tumor type, other treatment modalities may include radiation, chemotherapy, cryosurgery, topical medications, and photodynamic therapy.

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Section: Basal Cell Carcinomamentioning

confidence: 99%

Periocular Cutaneous Malignancies: A Review of the Literature

Slutsky

Jones

2012

Dermatologic Surgery

105

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“…For primary tumors existing data are insufficient to permit evidence-based choices among therapies,(Bath-Hextall et al ., 2004) which vary in cost. (Essers et al ., 2006; Otley, 2006; Wilson et al ., 2011) Substantial unexplained variations exist in treatment choices,(Chren, 2004) and the dearth of data has resulted in “competing camps” for different treatments. (Williford and Feldman, 2004)…”

Section: Introductionmentioning

confidence: 99%

Tumor Recurrence 5 Years after Treatment of Cutaneous Basal Cell Carcinoma and Squamous Cell Carcinoma

Chren

Linos

Torres

et al. 2013

Journal of Investigative Dermatology

155

134

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For most cutaneous basal cell and squamous cell carcinomas (nonmelanoma skin cancers [NMSC]) data are insufficient to permit evidence-based choices among treatments. To compare tumor recurrence after treatments, we conducted a prospective cohort study of consecutive patients with primary NMSC treated with the most common treatments in two practices in 1999–2000. Recurrence was determined from medical records by observers blinded to treatment type. 24.3% of tumors (N=361) were treated with destruction with electrodessication / curettage, 38.3% (N=571) with excision, and 37.4% (N=556) with histologically-guided serial excision (Mohs surgery). Follow-up was available for 1174 patients with 1488 tumors (93.8%) at median 7.4 years; overall 5-year tumor recurrence rate [95% Confidence Interval] was 3.3% [2.3, 4.4]. Unadjusted recurrence rates did not differ after treatments: 4.9% [2.3, 7.4] after destruction, 3.5% [1.8, 5.2] after excision, and 2.1% [0.6, 3.5] after Mohs surgery (P=0.26), and no difference was seen after adjustment for risk factors. In tumors treated only with excision or Mohs surgery, the hazard of recurrence was not significantly different, even after adjustment for propensity for treatment with Mohs surgery. These data indicate that common treatments for NMSC were at least 95% effective, and further studies are needed to guide therapeutic choices for different clinical subgroups.

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“…In 1998, a study was published showing there was little difference in cost between MMS ($1,243) and SSE with margin control using paraffin sections ($1,167). 6 Given the recent explosion in skin cancer incidence and its attendant treatment costs, there is further pressure to rein in health care expenditures on procedures with rapidly increasing usage, such as MMS and the cost efficacy of MMS continues to be debated. Thus, MMS potentially offered more than 10% and nearly 40% in savings than SSE with frozen section control in an office setting and ASC, respectively, when all of the costs were included.…”

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confidence: 99%