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Long-Term Outcomes With Mohs Surgery for Cutaneous Squamous Cell Carcinoma

By: Kayci Reyer
Posted: Thursday, August 29, 2019

According to a 5-year, multicenter, prospective cohort study published in the Journal of the American Academy of Dermatology, patients with cutaneous squamous cell carcinoma experienced significant survival benefits after undergoing Mohs surgery. The study also recommended that staging systems be employed as risk prognosticators.

“[Mohs surgery] is a highly effective treatment for [cutaneous squamous cell carcinoma] and may mitigate factors typically considered high risk,” concluded Amanda J. Tschetter, MD, of Dermatology Specialists Clinic in Edina, Minnesota, and colleagues.

Two staging systems—the American Joint Committee on Cancer Staging Manual (8th edition) and the Brigham and Women’s Hospital T-staging system—were used to evaluate the risk for local recurrence, nodal metastasis, and disease-specific death. Though both systems were able to predict nodal metastasis and disease-specific and all-cause death, neither was able to effectively predict local recurrence. In addition, although a statistical association was identified between Breslow depth and local recurrence, nodal metastasis, and disease-specific death, no such relationship was found between Breslow depth and incidental perineural invasion.

The 5-year study included 637 patients enrolled across multiple treatment centers. A total of 745 tumors were present among them. At a follow-up of 5 years, overall local recurrence-free survival was 99.3%, nodal metastasis–free survival was 99.2%, and disease-free survival was 99.4%.

According to the study authors, “the data presented represent the lowest 5-year local recurrence rate for any cutaneous squamous cell carcinoma treatment modality reported to date (1.6%).”

Disclosure: The study authors reported no conflicts of interest.



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