Hospital de la Princesa, Madrid, Spain.
Hospital Universitario Quirón Salud, Madrid, Spain.
Int J Dermatol. 2018 Nov;57(11):1375-1381. doi: 10.1111/ijd.14223. Epub 2018 Sep 23.
The two main tumors treated with Mohs micrographic surgery (MMS) are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). There are no studies analyzing whether MMS is different when treating these two types of tumors.
We aim to compare the characteristics of the patients, the tumors, and MMS, and first-year follow-up of MMS in BCC and SCC.
REGESMOHS is a prospective cohort study of patients treated with MMS. The participating centers are 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patients, tumors, and surgery were recorded. The follow-up was done with two visits: the first visit within 1 month after surgery and the second one within the first year.
From July 2013 to April 2017, a total of 2,669 patients who underwent MMS were included in the registry. Of them, 2,448 (93%) were diagnosed with BCC, and 181 (7%) were diagnosed with SCC. Patients with SCC were older than those with BCC (median age 73 years vs. 68 years) and presented immunosuppression more frequently. The tumor size was significantly larger in the SCC group. Regarding surgery, deeper invasion was more frequent in SCC, resulting in larger defects. Despite this, SCC did not require more stages to get clear margins or more time in the operating room. Incomplete Mohs was more frequent in the SCC group (6%) than in the BCC group (2%). The incidence of perioperative complications was higher when treating SCC. There were more relapses in the first-year follow-up in the SCC group.
There are significant differences when comparing MMS in BCC and SCC. Knowledge of these differences can help to prepare the patient and plan the surgery, optimizing results.
Mohs 显微外科手术（MMS）主要治疗两种肿瘤，基底细胞癌（BCC）和鳞状细胞癌（SCC）。目前尚无研究分析 MMS 治疗这两种类型的肿瘤是否存在差异。
我们旨在比较 MMS 治疗 BCC 和 SCC 患者、肿瘤和 MMS 的特征，以及 MMS 术后 1 年的随访情况。
REGESMOHS 是一项 MMS 治疗患者的前瞻性队列研究。参与的中心是 19 家西班牙医院，这些医院每周至少进行一次 MMS。记录患者、肿瘤和手术的特征数据。随访通过两次就诊进行：第一次在手术后 1 个月内，第二次在术后第 1 年。
2013 年 7 月至 2017 年 4 月，共纳入 2669 例行 MMS 的患者。其中，2448 例（93%）诊断为 BCC，181 例（7%）诊断为 SCC。SCC 患者比 BCC 患者年龄更大（中位年龄 73 岁 vs. 68 岁），且更常伴有免疫抑制。SCC 组肿瘤大小显著更大。在手术方面，SCC 肿瘤的侵袭更深，导致更大的缺损。尽管如此，SCC 获得切缘清晰并不需要更多的手术阶段，也不需要更长的手术时间。SCC 组的不完全 MMS 更为常见（6%），而 BCC 组则为（2%）。SCC 组的围手术期并发症发生率更高。在术后 1 年的随访中，SCC 组的复发率更高。
MMS 治疗 BCC 和 SCC 存在显著差异。了解这些差异有助于为患者做好准备并规划手术，从而优化治疗效果。
