Hruza G J
Cutaneous Surgery Center, Washington University School of Medicine, St. Louis, Missouri 63110.
J Dermatol Surg Oncol. 1994 Sep;20(9):573-7. doi: 10.1111/j.1524-4725.1994.tb00149.x.
Even though 5-year cure rates are as high as 99% for Mohs micrographic surgery (MMS) of cutaneous carcinomas, theoretically 100% cure rates of unifocal carcinomas should be possible.
To determine why cutaneous malignancies recur locally (persist) after MMS.
A retrospective study of all cutaneous malignancies treated with MMS during a 4-year period at Washington University School of Medicine was made. All lesions that were locally recurrent after previous MMS were analyzed for any possible cause of the recurrence.
Of 2,414 cutaneous malignancies treated, 33 (1.4%) were locally recurrent after previous MMS by four different Mohs surgeons and five separate technicians. Technical or interpretation problems that could have accounted for the local recurrence were identified in 77% of the lesions. The mean time to recurrence was 38.5 months, with 20% developing more than 5 years after the initial MMS.
MMS local recurrences are rare with procedural errors representing a majority of them. Five-year cure rates for basal cell carcinoma may somewhat overestimate the ultimate cure rate.
尽管皮肤癌的莫氏显微描记手术（MMS）5年治愈率高达99%，但理论上，单灶性癌的治愈率应可达100%。
确定皮肤恶性肿瘤在接受MMS治疗后为何会局部复发（持续存在）。
对华盛顿大学医学院4年间接受MMS治疗的所有皮肤恶性肿瘤进行回顾性研究。分析所有既往接受MMS治疗后局部复发的病灶，寻找复发的任何可能原因。
在接受治疗的2414例皮肤恶性肿瘤中，由4位不同的莫氏外科医生和5名不同的技术人员操作，有33例（1.4%）在既往MMS治疗后出现局部复发。在77%的病灶中发现了可能导致局部复发的技术或解读问题。复发的平均时间为38.5个月，其中20%在初次MMS治疗5年多后复发。
MMS治疗后局部复发很少见，其中大多数是由操作失误导致的。基底细胞癌的5年治愈率可能会略微高估最终治愈率。
