Abstract
BACKGROUNDThere are limited published data comparing wide local excision (WLE) with Mohs micrographic surgery (MMS) for the treatment of melanoma.OBJECTIVETo describe a novel treatment algorithm for the surgical management of head and neck melanoma and compare rates of local recurrence for tumors treated with either MMS using immunohistochemistry or WLE.MATERIALS AND METHODSA 10-year retrospective chart review including all in situ and invasive melanomas of the head and neck treated at one institution from January 2004 to June 2013.RESULTSAmong 388 patients with melanoma, MMS was associated with decreased rates of local recurrence (p =.0012). However, patient and tumor characteristics varied significantly, and WLE subgroup was largely composed of higher stage and risk tumors. Subgroup analysis found that patients with in situ or thin invasive tumors (<0.8 mm) treated with MMS had improved local recurrence outcomes (p =.0049), despite more frequent tumor location on high risk anatomic sites (e.g., central face). In addition, MMS was associated with a favorable delay in time to local recurrence among in situ tumors (HR = 31.8; p =.0148).CONCLUSIONThese findings further support the use of MMS for treatment of melanoma of the head and neck and help to validate our proposed clinical decision tree.
Original language | English (US) |
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Pages (from-to) | 381-389 |
Number of pages | 9 |
Journal | Dermatologic Surgery |
Volume | 45 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2019 |
Bibliographical note
Publisher Copyright:© 2018 by the American Society for Dermatologic Surgery, Inc.