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Majority of skin cancers appropriate for Mohs micrographic surgery

In light of recent appropriate-use criteria, researchers have found Mohs micrographic surgery was an appropriate treatment in 72% of skin cancers.

Within the University of Virginia Health System, researchers retrospectively reviewed patient and tumor data for all biopsy-proven skin cancers other than invasive melanoma from an 8-month period to determine the proportion that met appropriate-use criteria. Each skin cancer was classified as appropriate, inappropriate or uncertain based on the criteria.

Of the 1,059 skin cancers reviewed, 72% were deemed appropriate for Mohs micrographic surgery (MMS). MMS treatment was considered inappropriate in 20.4%, and in 7.6% of cancers, the appropriateness was uncertain, according to the researchers.

Squamous cell carcinomas had the highest proportion of cases (90.6%) in the appropriate category. Basal cell carcinomas were appropriate for MMS treatment in 67.3% of cases, and the melanoma in situ group had 67.9% cases that were deemed appropriate. As for rare skin cancers, 50% were appropriate and 50% were uncertain.

Among the skin cancers that met appropriate use criteria for MMS treatment, 59.3% were in H and M areas, including the head, neck, feet, ankles, genitalia, nipples/areola and pretibital surface.

“Better understanding of H and M areas by both dermatologists and especially non-dermatologists may lead to more skin cancers appropriate for MMS to be ultimately referred and treated with MMS,” the researchers wrote.

Disclosure: The authors have no relevant financial disclosures.