Mohs micrographic surgery versus wide local excision for head and neck melanoma-in-situ,
Kevin Phan , MD, James Onggo , MD & Asad Loya , BS
Received 05 Jun 2019, Accepted 27 Jun 2019, Accepted author version posted online: 02 Jul 2019
Download citation https://doi.org/10.1080/09546634.2019.1639605
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Accepted author version
Abstract
Background: Various surgical options can be used to remove melanoma in situ (MIS). These include wide local excision (WLE), staged excision, and Mohs micrographic surgery (MMS). For MIS lesions located in the head and neck regions, the WLE approach may not always be a technically feasible option if both cosmesis and anatomical function is to be preserved.
Methods: We performed a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) cancer registry. A total of 7933 cases of MIS in the head and neck region were included in this study, of which 5353 cases were treated by WLE and the remaining 2580 cases by MMS.
Results: Comparing between the WLE and MMS group, cancer-specific survival rates at 5 (99% vs 99%) and 10 years (98% vs 98%) as well as the 5 year overall survival rate (85% vs 86%) were similar. After adjusting for confounders, there was no significant difference in cancer-specific survival (HR: 0.902, 95%CI: 0.539-1.511, p = 0.695) and overall-survival (HR: 0.943, 0.813-1.093, p = 0.435).
Conclusions: For cosmetic and functional purposes, MMS is a valid and suitable alternative to WLE to treat MIS due to its tissue-preserving nature particularly in the head and neck region.
Key points
Our adjusted analysis demonstrates similar overall and cancer-specific survival for Mohs surgery vs wide local excision for head and neck melanoma-in-situ
For cosmetic and functional purposes, MMS is a valid and suitable alternative to WLE to treat MIS
This is due to its tissue-preserving nature particularly in the head and neck region
Keywords: Mohs micrographic surgery, melanoma-in-situ, melanoma, wide local excision, head and neck
Kevin Phan , MD, James Onggo , MD & Asad Loya , BS
Received 05 Jun 2019, Accepted 27 Jun 2019, Accepted author version posted online: 02 Jul 2019
Download citation https://doi.org/10.1080/09546634.2019.1639605
Select Language▼
Translator disclaimer
Accepted author version
Abstract
Background: Various surgical options can be used to remove melanoma in situ (MIS). These include wide local excision (WLE), staged excision, and Mohs micrographic surgery (MMS). For MIS lesions located in the head and neck regions, the WLE approach may not always be a technically feasible option if both cosmesis and anatomical function is to be preserved.
Methods: We performed a retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) cancer registry. A total of 7933 cases of MIS in the head and neck region were included in this study, of which 5353 cases were treated by WLE and the remaining 2580 cases by MMS.
Results: Comparing between the WLE and MMS group, cancer-specific survival rates at 5 (99% vs 99%) and 10 years (98% vs 98%) as well as the 5 year overall survival rate (85% vs 86%) were similar. After adjusting for confounders, there was no significant difference in cancer-specific survival (HR: 0.902, 95%CI: 0.539-1.511, p = 0.695) and overall-survival (HR: 0.943, 0.813-1.093, p = 0.435).
Conclusions: For cosmetic and functional purposes, MMS is a valid and suitable alternative to WLE to treat MIS due to its tissue-preserving nature particularly in the head and neck region.
Key points
Our adjusted analysis demonstrates similar overall and cancer-specific survival for Mohs surgery vs wide local excision for head and neck melanoma-in-situ
For cosmetic and functional purposes, MMS is a valid and suitable alternative to WLE to treat MIS
This is due to its tissue-preserving nature particularly in the head and neck region
Keywords: Mohs micrographic surgery, melanoma-in-situ, melanoma, wide local excision, head and neck
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