Background

Mohs micrographic surgery (MMS) should lead to tissue sparing of healthy skin compared with standard surgical excision because smaller surgical margins are used.

Objective

To quantify the tissue-sparing properties of MMS in primary basal cell carcinoma (BCC) with an infiltrative growth pattern.

Methods

A prospective study including 256 primary BCCs with an infiltrative growth pattern was performed. Tumor sizes were measured in 2 perpendicular directions. Surface defect areas after MMS were measured. The suspected defect surface area with standard excision using a 5-mm margin was calculated. The primary outcome of this study was the size of the defect surface area spared with MMS compared with the calculated defect surface area with a standard excision.

Results

The median tumor size was 71 mm², and the median defect size after MMS was 154 mm². The median defect size calculated for standard surgical excision was 298 mm². We have shown that MMS of BCC with an infiltrative growth pattern had a 46.4% tissue-sparing effect when compared with standard surgical excision (95% confidence interval, 43.4%-49.1%; P value < .001).

Limitations

Single-center study design. Lack of a randomized control group for ethical reasons.

Conclusion

A rate of tissue sparing of 46% can be reached by using MMS for primary BCC with an infiltrative growth pattern.

中文翻译：

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Mohs显微外科手术治疗浸润性基底细胞癌的组织保留特性

背景

与标准手术切除相比，莫氏显微外科手术（MMS）可以节省健康皮肤的组织，因为使用的手术切缘较小。

客观的

若要量化具有浸润性生长模式的原发性基底细胞癌（BCC）中MMS的保留组织特性。

方法

进行了一项前瞻性研究，包括256个具有浸润性生长模式的原发性BCC。在两个垂直方向上测量肿瘤大小。测量了MMS之后的表面缺陷区域。通过标准切除（使用5 mm的余量）计算出可疑的缺陷表面积。这项研究的主要结果是与标准切除术相比，MMS保留的缺损表面积的大小与计算出的缺损表面积相比。

结果

中位肿瘤大小为71 mm ²，MMS后中位缺陷大小为154 mm ²。计算出的标准手术切除的中位缺损大小为298 mm ²。我们已经显示，具有浸润性生长模式的BCC的MMS与标准手术切除相比具有46.4％的组织保留效应（95％置信区间，43.4％-49.1％；P值<.001）。

局限性

单中心研究设计。出于道德原因缺乏随机对照组。

结论

通过将MMS用于具有浸润性生长模式的原发性BCC，可以达到46％的组织保留率。