Dermatologic surgeryTissue-sparing properties of Mohs micrographic surgery for infiltrative basal cell carcinoma
Section snippets
Study participants
A prospective observational study in patients treated with MMS was performed at Leiden University Medical Center in 2017-2018. Patients were mostly referred by dermatologists. For all patients, the standard procedures were followed for MMS of basal cell carcinoma. The following patients were excluded: patients with recurrent or residual tumors, patients with tumors with solely a nodular or superficial growth pattern, and patients with tumors other than BCC.
Procedures
Before surgery, the tumor was measured
Results
A total of 256 tumors were removed by MMS. For patient demographics, see Table I. The median age was 70 years (range, 35-94). The average maximum tumor length was 13 mm, and the median of calculated tumor surface area was 71 mm2. The median defect size was 154 mm2. The median defect size calculated for standard surgical excision was 298 mm2. All tumors were located in the facial (n = 244) or scalp (n = 12) region (see Table II for locations). The majority of the tumors were located on the nose
Discussion
Overall, we have shown that for removal of infiltrative growing BCCs, MMS has a tissue-sparing effect of 43% to 49% compared with standard excision. In 8.6% of the tumors, standard excision with a 5-mm margin would have led to inadequate tumor removal. The tissue-sparing effect is higher for tumors on the nose and reasonably lower for tumors on the cheek and frontotemporal region (28.0% and 20.6%, respectively). The percentage of tumors in which standard excision would have led to inadequate
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Funding sources: None.
Conflicts of interest: None disclosed.