Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer- Basal Cell Carcinoma or Squamous Cell Carcinoma- Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study
Román Miñano Medrano 1 , José L López Estebaranz 2 , Onofre Sanmartin-Jiménez 3 , Joan R Garcés 4 , Manuel A Rodríguez-Prieto 5 , Eva Vilarrasa-Rull 4 , Esther de Eusebio-Murillo 6 , Begoña Escutia-Muñoz 7 , Ángeles Flórez-Menéndez 8 , Juan L Artola-Igarza 9 , Alberto Alfaro-Rubio 10 , Pedro Redondo 11 , Yolanda Delgado-Jiménez 12 , Julia M Sánchez-Schmidt 13 , Irati Allende-Markixana 14 , María L Alonso-Pacheco 15 , Beatriz García-Bracamonte 16 , Pablo de la Cueva-Dobao 17 , Raquel Navarro-Tejedor 18 , Cristina Ciudad-Blanco 19 , Lucía Carnero-González 20 , Hugo Vázquez-Veiga 21 , Natividad Cano-Martínez 22 , Verónica Ruiz-Salas 4 , Pedro Sánchez-Sambucety 5 , Rafael Botella-Estrada 7 , Beatriz González-Sixto 8 , Antonio Martorell-Calatayud 10 , Pilar Gil 11 , Victoriano Morales-Gordillo 23 , Agustí Toll-Abelló 13 , Izascun Ocerin-Guerra 14 , Matías Mayor-Arenal 15 , Ricardo Suárez-Fernández 24 , Laura Sainz-Gaspar 21 , Miguel A Descalzo 25 , Ignacio Garcia-Doval 25
Background: Patients diagnosed of keratinocyte cancer (basal cell carcinoma and cutaneous squamous cell carcinoma) or non-melanoma skin cancer (NMSC) have a higher risk of develop a second cutaneous malignant neoplasm.
Objective: Our aim was to describe the frequency, incidence rate and risk factor predisposing to develop a second neoplasm in a patients cohort treated with Mohs Micrographic Surgery (MMS).
Methods: Prospective cohort of consecutive patients undergoing MMS in 22 representative Spanish centres (July 2013-February 2020) REGEMOHS. Variables analysed in a logistic multilevel multivariate analysis included characteristic of patients, frequency of second cutaneous neoplasm, incidence rate and risk factors.
Results: 4768 patients underwent MMS: 4397 (92%) basal cell carcinoma and 371 (8%) cutaneous squamous cell carcinoma. Mean follow up was 2,4 years. A second malignant neoplasm was diagnosed in 1201 patients (25%). 1013 (21%) were basal cell carcinomas; 154 (3%) cutaneous squamous cell carcinoma and 20 (0,4) melanomas. Incidence rate was 107 (101-113) cases per 1000 person-year for any tumour; 90 (85-96) basal cell carcinoma, 14 (12-16) cutaneous squamous cell carcinoma and 2 (1-3) melanoma. Significant risk factors for developing a second cutaneous malignant neoplasm were previous history of multiple tumours before diagnosis (RR: 4.6 95% CI: 2.9-7.1), immunosuppression (RR: 2.1 95% CI: 4-3.1) and male (RR: 1.6 95% CI: 1.4-1.9).
Conclusion: Patients diagnosed of keratinocyte carcinoma who underwent MMS have a higher risk for developing a second cutaneous malignant neoplasm. These are more frequent in patients with previous history of multiple neoplasm, immunosuppression and males.
CITATION Actas Dermosifiliogr. 2022 May;113(5):T451-T458.
doi: 10.1016/j.ad.2022.01.035. Epub 2022 Apr 15.