Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Dermatology, University Medical Center Groningen, Groningen, The Netherlands.
Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
J Am Acad Dermatol. 2019 Jun;80(6):1700-1703. doi: 10.1016/j.jaad.2019.01.057. Epub 2019 Jan 31.
Mohs micrographic surgery (MMS) should lead to tissue sparing of healthy skin compared with standard surgical excision because smaller surgical margins are used.
To quantify the tissue-sparing properties of MMS in primary basal cell carcinoma (BCC) with an infiltrative growth pattern.
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.
The median tumor size was 71 mm, and the median defect size after MMS was 154 mm. The median defect size calculated for standard surgical excision was 298 mm. 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).
Single-center study design. Lack of a randomized control group for ethical reasons.
A rate of tissue sparing of 46% can be reached by using MMS for primary BCC with an infiltrative growth pattern.
与标准手术切除相比，Mohs 显微外科手术（MMS）由于使用了较小的手术边缘，因此应该可以保留健康皮肤的组织。
定量评估 MMS 在具有浸润性生长模式的原发性基底细胞癌（BCC）中的组织保留特性。
进行了一项前瞻性研究，纳入了 256 例具有浸润性生长模式的原发性 BCC。在 2 个垂直方向上测量肿瘤大小。测量 MMS 后表面缺损面积。计算使用 5mm 边缘的标准切除的可疑缺损面积。本研究的主要结局是 MMS 与标准切除相比，保留的缺损表面面积的大小。
中位肿瘤大小为 71mm，MMS 后中位缺损大小为 154mm。标准手术切除计算的中位缺损大小为 298mm。我们已经表明，与标准手术切除相比，MMS 对具有浸润性生长模式的 BCC 具有 46.4%的组织保留作用（95%置信区间，43.4%-49.1%；P 值<.001）。
单中心研究设计。由于伦理原因，缺乏随机对照组。
对于具有浸润性生长模式的原发性 BCC，使用 MMS 可达到 46%的组织保留率。
