Scientific publications

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

Nov 1, 2018 | Magazine: International Journal of Dermatology

Yolanda Delgado Jiménez  1   2 , Celia Camarero-Mulas  1 , Onofre Sanmartín-Jiménez  3 , Joan R Garcés  4   5 , Manuel à Rodríguez-Prieto  6 , Teresa Alonso-Alonso  6 , Roman Miñano Medrano  7 , Jose L López-Estebaranz  7 , Esther de Eusebio Murillo  8 , Pedro Redondo  9 , Cristina Ciudad-Blanco  10   11 , Agusti Toll  12 , Juan L Artola Igarza  13 , Irati Allende Markixana  14 , Ricardo Suarez Fernández  11 , Alberto Alfaro Rubio  15 , Marãa L Alonso Pacheco  16 , Hugo Vázquez-Veiga  17 , Pablo de la Cueva Dobao  18 , Verónica Ruiz-Salas  4 , Eva Vilarrasa  4   5 , Lucia Barchino  10 , Victoriano Morales-Gordillo  2 , Izascun Ocerin-Guerra  14 , Raquel Navarro Tejedor  1 , Luis Hueso  15 , Matias Mayor Arenal  16 , Maria J Seoane-Pose  17 , Natividad Cano-Martinez  10   18 , Ignacio Garcia-Doval  19 , Miguel A Descalzo  19 , REGESMOHS

Background: The two main tumors treated with Mohs micrographic surgery (MMS) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). There are no studies analyzing whether MMS is different when treating these two types of tumors.

Objective: We aim to compare the characteristics of the patients, the tumors, and MMS, and first-year follow-up of MMS in BCC and SCC.

Methods: REGESMOHS is a prospective cohort study of patients treated with MMS. The participating centers are 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patients, tumors, and surgery were recorded. The follow-up was done with two visits: the first visit within 1 month after surgery and the second one within the first year.

Results: From July 2013 to April 2017, a total of 2,669 patients who underwent MMS were included in the registry. Of them, 2,448 (93%) were diagnosed with BCC, and 181 (7%) were diagnosed with SCC. Patients with SCC were older than those with BCC (median age 73 years vs. 68 years) and presented immunosuppression more frequently. The tumor size was significantly larger in the SCC group. Regarding surgery, deeper invasion was more frequent in SCC, resulting in larger defects. Despite this, SCC did not require more stages to get clear margins or more time in the operating room. Incomplete Mohs was more frequent in the SCC group (6%) than in the BCC group (2%). The incidence of perioperative complications was higher when treating SCC. There were more relapses in the first-year follow-up in the SCC group.

Conclusion: There are significant differences when comparing MMS in BCC and SCC. Knowledge of these differences can help to prepare the patient and plan the surgery, optimizing results.

CITATION  Int J Dermatol. 2018 Nov;57(11):1375-1381. doi: 10.1111/ijd.14223. Epub 2018 Sep 23. 

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