Mohs surgery ‘potentially effective’ in all AJCC staging compared with wide local excision

Key takeaways:

• At year 10, overall survival was 90.2% in the Mohs micrographic surgery group vs. 88.3% in the wide local excision group.
• Short-term morbidity outcomes were also improved with Mohs surgery.

CHICAGO — Mohs micrographic surgery showed increased overall survival compared with wide local excising in melanoma, according to a study presented at the American Society for Dermatologic Surgery Annual Meeting.

“Our study sought to compare the clinical outcomes between Mohs and wide local excision,” Ajay N. Sharma, MD, MBA, a dermatology resident at University of California, Irvine, said during his presentation.

Using the global TriNetX database, researchers identified all patients with melanoma, split them into Mohs micrographic surgery (MMS; n = 5,965) and wide local excision (WLE; n = 48,099) cohorts and propensity score matched for age, sex, race and American Joint Committee on Cancer staging.

They then evaluated overall survival, as well as short-term morbidity outcomes including infection, bleeding, hematoma, emergency room visits and hospitalizations.

Overall survival at year 10 was 90.2% for the MMS cohort and 88.3% for the WLE cohort, which was a statistically significant difference.

“Putting these results into context, we can say that Mohs is potentially effective for all AJCC staging,” Sharma said. “It led to improved overall survival for up to 10 years and propensity score matching helps mitigate some of the confounders commonly seen in these types of analyses.”

In terms of short-term morbidity measures, infection, bleeding and hematoma were all improved in the MMS group compared with the WLE group.

Additional prospective, randomized controlled trials are needed to confirm these findings.