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.

中文翻译：

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头颈部黑色素瘤具有局部复发风险高的特征，比基底细胞癌和鳞状细胞癌更需要组织重组重建：13,664 例肿瘤重建前显微切缘控制的适应证比较

背景

基于高局部复发风险特征和组织重排重建，共识指南建议对角化细胞癌 (KC) 进行显微镜切缘控制，但不适用于皮肤黑色素瘤。

客观的

比较头颈部 KC 与黑色素瘤的高局部复发风险特征和组织重排重建的频率。

方法

在宾夕法尼亚大学医院用 Mohs 显微手术治疗 KC 与黑色素瘤的回顾性队列研究。

结果

从前瞻性更新的 Mohs 显微手术数据库中确定了总共 12,189 个 KC（8743 个基底细胞癌和 3343 个鳞状细胞癌）和 1475 个黑色素瘤（1065 个原位黑色素瘤和 410 个侵袭性黑色素瘤）。与 KC 相比，黑色素瘤更可能具有高局部复发风险特征，包括术前尺寸较大（2.10 厘米对 1.30 厘米 [ P  < .0001]）、复发状态（5.08% 对 3.91% [ P  = .031]） ) 和亚临床传播（31.73% 对 26.52% [ P  < .0001]）。与 KCs 相比，黑色素瘤的组织重排重建明显更常见（44.68% 对 33.02% [ P  < .0001]；优势比，1.98 [ P  < .0001]）。

限制

这是一项回顾性研究，并没有将结果与其他治疗方法的结果进行比较，例如慢莫氏或常规切除。

结论

头颈部黑色素瘤具有较高的局部复发风险特征，并且比 KC 更频繁地需要组织重排重建。