Melanomas of the head and neck have high–local recurrence risk features and require tissue-rearranging reconstruction more commonly than basal cell carcinoma and squamous cell carcinoma: A comparison of indications for microscopic margin control prior to reconstruction in 13,664 tumors - 08/07/21
Abstract |
Background |
On the basis of high–local recurrence risk features and tissue-rearranging reconstruction, consensus guidelines recommend microscopic margin control for keratinocyte carcinomas (KCs) but not for cutaneous melanoma.
Objective |
To compare high–local recurrence risk features and frequency of tissue-rearranging reconstruction for head and neck KC with those for melanoma.
Methods |
Retrospective cohort study of KC versus melanoma treated at the Hospital of the University of Pennsylvania with Mohs micrographic surgery.
Results |
A total of 12,189 KCs (8743 basal cell carcinomas and 3343 squamous cell carcinomas) and 1475 melanomas (1065 melanomas in situ and 410 invasive melanomas) were identified from a prospectively updated Mohs micrographic surgery database. Compared with KCs, melanomas were significantly more likely to have high–local recurrence risk features, including larger preoperative size (2.10 cm vs 1.30 cm [P < .0001]), recurrent status (5.08% vs 3.91% [P = .031]), and subclinical spread (31.73% vs 26.52% [P < .0001]). Tissue-rearranging reconstruction was significantly more common for melanoma than for KCs (44.68% vs 33.02% [P < .0001]; odds ratio, 1.98 [P < .0001]).
Limitations |
This was a retrospective study, and it did not compare outcomes with those of other treatment methods, such as slow Mohs or conventional excision.
Conclusion |
Melanomas of the head and neck have high–local recurrence risk features and require tissue-rearranging reconstruction more frequently than KCs do.
Le texte complet de cet article est disponible en PDF.Key words : appropriate use criteria, basal cell carcinoma, flap, graft, guidelines, melanoma, Mohs micrographic surgery, nonmelanoma skin cancer, recurrence risk, squamous cell carcinoma, subclinical spread, tissue-rearranging reconstruction
Abbreviations used : BCC, CI, KC, MMS, MMS-I, SCC, slow Mohs
Plan
| Funding sources: Dr Sobanko and Dr Etzkorn received support from Dermatology Foundation Career Development Awards. |
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| Conflicts of interest: None disclosed. |
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| Reprints not available from the authors. |
Vol 85 - N° 2
P. 409-418 - août 2021 Retour au numéro
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