Mohs Surgery

McGovern, Thomas W.; Leffell, David J.

doi:10.1001/archderm.135.10.1255

Cited by 28 publications

(12 citation statements)

References 41 publications

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“…The minimum important difference in recurrence rates between therapies has not been established (Shuster, 1999), although some have acknowledged that a difference in recurrence rates of 4% might be considered clinically unimportant (McGovern and Leffell, 1999). We detected a difference between excision and Mohs surgery of 1.4% [−0.5, 3.5], and suggest that because the confidence limits exclude 4%, our results indicate that the treatments did not differ significantly in preventing recurrence in our practice settings.…”

Section: Discussionmentioning

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

160

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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Section: Discussionmentioning

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

160

134

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“… † Recurrence rates following excision using the Mohs' microscopically controlled technique for the treatment of recurrent basal cell carcinoma range from 3.4 to 7.3% 4,39–44 …”

Section: Discussionmentioning

confidence: 99%

Basal Cell Carcinoma with Mixed Histology: A Possible Pathogenesis for Recurrent Skin Cancer

Cohen

Schulze²,

Nelson³

2006

Dermatol Surg

111

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More than 40% of basal cell carcinomas referred for removal of the residual tumor were BCC-MH. An unsuspected aggressive pathologic pattern of growth may not be detected after a superficial biopsy. Subsequently, the cancer may recur if the initial treatment for the diagnosed nonaggressive tumor subtype is inadequate for the undiscovered aggressive carcinoma. Mohs micrographic surgery is recommended for BCC-MH treatment.

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“…5 It is widely accepted that MMS is the most effective current method for removal of aggressive BCC in terms of compromise between maximum conservation of healthy skin and minimum recurrence rates. [6][7][8] While 5-yr recurrence rates for BCC treated by MMS are 1.4% for primary tumors and 4% for recurrent tumors, 9 for standard excision, this rate reaches 3.2 to 10% for primary tumors, and more than 17% for recurrent BCCs. 10 It has also been reported that at shorter follow-up periods ͑18 months͒, MMS was considerably more advantageous than surgical excision especially for recurrent tumors 7 ͑recurrence rate 0 versus 3%͒.…”

Section: Introductionmentioning

confidence: 99%

Development of Raman microspectroscopy for automated detection and imaging of basal cell carcinoma

et al. 2009

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We investigate the potential of Raman microspectroscopy (RMS) for automated evaluation of excised skin tissue during Mohs micrographic surgery (MMS). The main aim is to develop an automated method for imaging and diagnosis of basal cell carcinoma (BCC) regions. Selected Raman bands responsible for the largest spectral differences between BCC and normal skin regions and linear discriminant analysis (LDA) are used to build a multivariate supervised classification model. The model is based on 329 Raman spectra measured on skin tissue obtained from 20 patients. BCC is discriminated from healthy tissue with 90+/-9% sensitivity and 85+/-9% specificity in a 70% to 30% split cross-validation algorithm. This multivariate model is then applied on tissue sections from new patients to image tumor regions. The RMS images show excellent correlation with the gold standard of histopathology sections, BCC being detected in all positive sections. We demonstrate the potential of RMS as an automated objective method for tumor evaluation during MMS. The replacement of current histopathology during MMS by a "generalization" of the proposed technique may improve the feasibility and efficacy of MMS, leading to a wider use according to clinical need.

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Mohs Surgery

Cited by 28 publications

References 41 publications

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

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

Basal Cell Carcinoma with Mixed Histology: A Possible Pathogenesis for Recurrent Skin Cancer

Development of Raman microspectroscopy for automated detection and imaging of basal cell carcinoma

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