Premium
Mohs micrographic surgery for basal cell carcinomas: results of a Spanish retrospective study and Kaplan–Meier survival analysis of tumour recurrence
Author(s) -
Català A.,
Garces J.R.,
Alegre M.,
Gich I.J.,
Puig L.
Publication year - 2014
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.12293
Subject(s) - medicine , hazard ratio , basal cell carcinoma , confidence interval , retrospective cohort study , proportional hazards model , surgery , multivariate analysis , medical record , mohs surgery , biopsy , survival analysis , basal cell
Background Mohs micrographic surgery ( MMS ) is a specialized procedure usually limited to specific indications (e.g. high‐risk basal cell carcinomas [ BCC s]). Objective To determine the recurrence rate of MMS for BCC at a tertiary referral centre in Barcelona, Spain. Methods Review of medical records of patients undergoing 534 consecutive MMS interventions for confirmed BCC s. The main outcome measure was biopsy‐proven recurrence of BCC at the same anatomical location after MMS . Results A total of 489 patients underwent MMS for 534 BCC s from April 1999 to December 2011. The patients’ mean age was 66 years. The most frequent location was the nasal/perinasal region (38.4%, n = 205). The surgical interventions of 47.9% ( n = 256) were for primary BCC s and 52.1% ( n = 278) procedures were for recurrent or residual BCC s. The mean follow‐up was 30.5 months (range 1–145 months). Thirty‐two recurrences were identified in total. The raw recurrence rate following MMS for primary BCC s was 1.2% (3/256) compared to 10.4% (32/278) for recurrent BCC . On multivariate analysis (Cox proportional hazard model) only prior treatment ( P = 0.018, hazard ratio [ HR ] 4.68 with 95% confidence intervals [ CI ] 1.30–16.79), multiple prior treatments ( P = 0.013, HR 2.72 [95% CI 1.24–5.96]), and healing by secondary intention ( P = 0.041, HR 2.88 [95% CI 1.04–7.97]) were independent prognostic factors of recurrence after MMS . Limitations The limitations of our study are those of a retrospective study. Conclusion Mohs micrographic surgery for primary high‐risk BCC s has a high success rate but the cumulative probability of recurrence increases significantly when tumours with recurrences are referred for MMS .