MICHAELBIGBYMDDAMIANOABENIMD, MPHROSAMARIACORONADSc, MDURBÀGONZÁLEZMD, PhDARBAR A.QURESHIMD, MPHMOYSESSZKLOMD, MPH, DrPHHYWELWILLIAMSMSc, PhD, FRCP
Question: In patients with large, aggressive, or recurrent facial basal cell carcinomas (BCCs), does surgical excision (SE) or Mohs micrographic surgery (MMS) produce lower recurrence rates?
Setting: Patients treated in 2 hospitals in the Netherlands (University Hospital Maastricht or the Laurentius Hospital Roermond).
Design: The study used a randomized controlled study design and included patients with primary or recurrent BCC. Primary carcinoma was defined as either (1) untreated, larger than 1 cm in diameter, and in the H-zone of the face, or (2) aggressive histopathological subtype, such as morpheaform type, in the face. Recurrent carcinomas were limited to those that were histologically confirmed and on the face. Surgical excision was standardized by mandating 3-mm margins. If the resected margins were found to be positive, a re-excision with a 3-mm margin was performed. If the margins remained positive after the second SE, the patient underwent MMS. The authors looked at recurrence of the carcinoma as their primary outcome and incomplete excision, aesthetic results, and costs as their secondary end points. Recurrence rates were analyzed by intention to treat.
Chen SC. Does Mohs Micrographic Surgery Produce Lower Recurrence Rates? Arch Dermatol. 2006;142(3):360–361. doi:10.1001/archderm.142.3.360
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