z-logo
Premium
Mohs micrographic surgery for basal cell carcinoma: evaluation of the indication criteria and predictive factors for extensive subclinical spread
Author(s) -
Hoorens I.,
Batteauw A.,
Van Maele G.,
Lapiere K.,
Boone B.,
Ongenae K.
Publication year - 2016
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14308
Subject(s) - subclinical infection , basal cell carcinoma , medicine , mohs surgery , basal (medicine) , predictive value , dermatology , oncology , surgery , basal cell , radiology , pathology , insulin
Summary Background The incidence of basal cell carcinoma ( BCC ) is rising and BCC treatment has an important impact on healthcare budget. Mohs micrographic surgery ( MMS ) has the highest 5‐year cure rate but is an expensive technique. Objectives To study the indication criteria for MMS , using a series of 1062 patients treated for facial BCC s between 1998 and 2011. Methods The accuracy of the indication criteria was evaluated by comparing the characteristics of BCC requiring one vs. more than one round of MMS . Predictors for extensive subclinical spread (three or more rounds) were examined using the preoperative patient and all tumour characteristics. Results BCC s with a surface > 1 cm 2 and aggressive histology (morphoeaform and micronodular), and a patient age > 80 years are strong predictors for two or more rounds of MMS being required. Extensive subclinical spread was present in recurrent tumours, morphoeaform BCC or BCC with mixed histology. Conclusions We found that tumour size and aggressive histology are the strongest indication criteria for MMS . Recurrence and aggressive histology are predictors for extensive subclinical spread but not for two or more rounds of MMS . Evidence‐based indications for MMS are necessary to ensure cost‐effective management of BCC .

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here