Mohs micrographic surgery may be superior to wide local excision for melanoma in situ

Treatment of melanoma in situ with Mohs micrographic surgery may have better outcomes than treatment with wide local excision, according to a study presented at AAD VMX 2021.

“The current standard of care for treating melanoma in situ (MIS) is by wide local excision (WLE),” Rahul Raiker, BS, of West Virginia University School of Medicine, and colleagues wrote. “Recent research has shown that Mohs micrographic surgery (MMS) is just as effective as WLE for treating MIS for long-term outcomes as there was no significant difference in recurrence and overall survival between the two procedures.”

The retrospective cohort study used a national federated real-time database to identify patients with melanoma in situ who underwent either WLE or MMS between 2006 and 2020, as well as to identify complications.

Patients in the MMS cohort had a statistically significant lower risk of developing cellulitis/lymphangitis (adjusted risk ratio = 0.38; 95% CI, 0.24-0.61), cutaneous infection (ARR = 0.52; 95% CI, 0.39-0.69), wound dehiscence (ARR = 0.48; 95% CI, 0.27-0.84) and hematoma (ARR = 0.44; 95% CI, 0.21-0.91), the study said.

“Treating MIS with MMS over WLE may be a superior option with improved short-term and long-term outcomes than WLE overall,” the authors wrote. “Additional studied are warranted to validate this finding, especially subgroup comparisons of MIS in different locations.”