Factors Affecting Recurrence and Costs of Basal Cell Carcinoma Undergoing Mohs Micrographic Surgery: A Hospital-Based Retrospective Cohort Study

Abstract

Background: Around 80% of the all non-melanoma skin cancer cases suffer from basal cell carcinoma (BCC). Mohs surgery is one of the common method used for treatment in recent years. There are several treatment methods for primary BCC. One of these methods is Mohs micrographic surgery (Mohs surgery), which has become popular in recent years. Objectives: The aim of this study was to investigate 4-year recurrence and factors affecting the recurrence of BCC patients after Mohs surgery. Methods: This is a retrospective cohort study. The study population included all BCCs, who underwent Mohs surgery in Alzarha Hospital in Isfahan between 2007 and 2014, and were monitored for recurrence for 4 years. Cox regression analysis was used to determine factors affecting time recurrence. Results: The most and least frequent locations of this disease are nose (30.3%) and body (0.5%). The most common locations for recurrence are scalp (50%), nose (15%), and around the eyes (15%). The 4-year recurrence frequency of BCC after Mohs surgery was 0.9%. Cox regression analysis relationship between determining factors affecting time recurrence was not significance. Conclusions: The causes of recurrence can include the less use of protective equipment in front of sunlight or low precision of doctors in the lesion surgery in locations of the body, arms, feet, head, neck, hands, legs or genital organs, and other parts of the body.

Recurrence of Basal Cell Carcinoma After Mohs Micrographic Surgery: A 4-Year Retrospective Analysis

“…Most of the patients were female although we could not find any significant difference between recurrence rat, age, and sex. In the previous studies, the incidence rate of BCC was reported to be more prevalent in females older than 60 years old which is in accordance whit the results of this study (15,19,22) while some investigation reported otherwise (14). This contradiction is probably due to the location of the study and the different ways it is done.…”

“…In different studies, the discrepancy in the result of the recurrence rate was mainly due to the differences in the study methods. In another study, Nassiripour et al (14) showed that the recurrence rate of patients who had the same history in Isfahan, is 9.5% after 4 years of follow-up, which was higher than the present study and the previous studies in Iran. They mentioned that these differences might be due to the investigation of BCC in all parts of the body while others studied the recurrence rate for face BCC.…”

“…Rowe et al reported that most BCC recurrence occurs less than 3 years after treatment (66%) and a small percentage of recurrences occur between 6 and 10 years after primary surgery (23). In the report of Nassiripour et al (14) regarding the rate of recurrence after surgery, it is stated that a large percentage of recurrences (85%) occur less than three years after surgery. In this study, the recurrence time in 66.7% was less than 15 months and 33.3% more than 15 months.…”

“…Although our results were consistent with previous studies (16,22,24) the type of research conducted has influenced this conclusion. The results of a study on the whole body showed that the most common lesion was in the scalp (50%), nose (15%), and around the eyes (15%) (14). Leibovitch et al in 3370 patients in a 5-year follow-up period after MMS, reported that the most common anatomic site was the nose followed by the cheek and maxilla (19).…”