BACKGROUND Outcomes for patients with cutaneous squamous cell carcinoma (CSCC) treated with Mohs micrographic surgery (MS) in the United States have never been prospectively defined. Risk factors as they relate to outcomes are primarily derived from single-institution, retrospective data without regard for treatment modality. The American Joint Committee on Cancer Staging Manual, Eighth Edition, and the Brigham and Women's Hospital T staging systems have not been prospectively validated. OBJECTIVE To prospectively quantify outcomes by T stage and verify historically high-risk features as they pertain to outcomes in MS-treated CSCC. METHODS A 5-year, prospective, multicenter analysis of patients undergoing MS for invasive CSCC was conducted. RESULTS The study enrolled 647 patients with 745 tumors. The 5-year local recurrence (LR)-free survival, nodal metastasis (NM)-free survival, and disease-specific survival were 99.3%, 99.2%, and 99.4%, respectively. Both staging systems were predictive of NM, disease-specific death, and all-cause death; neither was predictive of LR. Although Breslow depth was statistically associated with LR, NM, and disease-specific death, incidental perineural invasion was not. LIMITATIONS The Brigham and Women's Hospital and the American Joint Committee on Cancer Staging Manual, Eighth Edition T staging systems were published after study enrollment, therefore T stages were retrospectively applied using the prospectively collected data. CONCLUSION MS is a highly effective treatment for CSCC and may mitigate factors typically considered high risk. Uniform reporting of Breslow depth should be considered in CSCC. The American Joint Committee on Cancer Staging Manual, Eighth Edition, and the Brigham and Women's Hospital staging system are useful prognosticators but are not predictive of LR after MS.

中文翻译：

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使用Mohs显微外科手术治疗的浸润性皮肤鳞状细胞癌患者的长期临床结局：一项为期5年，多中心，前瞻性队列研究。

背景技术在美国，从未用Mohs显微照相术（MS）治疗的皮肤鳞状细胞癌（CSCC）患者的结果得到前瞻性的定义。与结果相关的风险因素主要来自单一机构的回顾性数据，不考虑治疗方式。美国癌症分期联合委员会手册，第八版，以及布莱根妇女医院的分期系统尚未经过前瞻性验证。目的通过T期前瞻性量化结局并验证历史高危特征，因为它们与MS治疗的CSCC中的结局有关。方法对进行MS的有创CSCC患者进行了为期5年的前瞻性，多中心分析。结果该研究招募了647例患有745例肿瘤的患者。5年无局部复发（LR）的存活率，无淋巴结转移（NM）的存活率和疾病特异性的存活率分别为99.3％，99.2％和99.4％。两种分期系统均可以预测NM，特定疾病死亡和全因死亡。两者均不能预测LR。尽管Breslow深度与LR，NM和特定疾病的死亡在统计学上相关，但偶然的神经周浸润并不相关。局限性布莱根妇女医院和美国癌症分期联合委员会手册，第八版T分期系统是在研究入组后出版的，因此使用前瞻性收集的数据回顾性地应用了T分期。结论MS是CSCC的一种高效治疗方法，可以减轻通常被认为高风险的因素。CSCC中应考虑统一报告Breslow深度。