Tumor recurrence of keratinocyte carcinomas judged appropriate for Mohs micrographic surgery using Appropriate Use Criteria

Content Provider	Scilit
Author	Stuart, Sarah E. Schoen, Patrick Jin, Chengshi Parvataneni, Rupa Arron, Sarah Linos, Eleni Boscardin, W. John Chren, Mary-Margaret
Copyright Year	2017
Description	Journal: Journal of the American Academy of Dermatology Background The use of Mohs micrographic surgery (MMS) has increased greatly to treat basal cell and cutaneous squamous cell carcinomas (keratinocyte carcinoma [KC]), and consensus-based Appropriate Use Criteria (AUC) were developed to identify tumors for which MMS is appropriate. Objective We sought to compare recurrence rates after different treatments in tumors judged appropriate for MMS. Methods We used data from an observational prospective cohort study and retrospectively categorized consecutive tumors as appropriate for MMS according to the AUC. Among appropriate tumors, we used survival analyses to compare 5-year recurrence rates after treatments. Results Among tumors appropriate for MMS (N = 1483), adjusted 5-year recurrence rates were 2.9% (range, 1.4-4.3%) after MMS, 5.5% (range, 3.1-7.9%) after excision, 4.0% (range, 0.6-7.2%) after destruction, and 5.9% (range, 1.5-10.2%) after other treatments. In tumors treated only with MMS or excision (the most similar subgroups), the adjusted hazard ratio of 5-year recurrence after MMS was 0.6 (95% confidence interval, 0.3-1.0; P = .06). Limitations This study is limited by its uncertain generalizability, lack of randomization, and unmeasured characteristics. Conclusion The AUC identified tumors for which recurrence would be less common after MMS than after excision, but the absolute difference in recurrence rates was small.
Related Links	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443650/pdf http://www.jaad.org/article/S0190962217300233/pdf
ISSN	01909622
e-ISSN	10976787
DOI	10.1016/j.jaad.2016.12.045
Journal	Journal of the American Academy of Dermatology
Issue Number	6
Volume Number	76
Language	English
Publisher	Elsevier BV
Publisher Date	2017-03-29
Access Restriction	Open
Subject Keyword	Journal: Journal of the American Academy of Dermatology Appropriate Use Criteria Basal Cell Carcinoma Cutaneous Squamous Cell Carcinoma Keratinocyte Carcinoma Mohs Micrographic Surgery Outcomes Research Hazard Ratio National Comprehensive Cancer Network Squamous Cell Carcinoma University-based Dermatology Clinic
Content Type	Text
Resource Type	Article
Subject	Dermatology