Basal cell carcinoma treated with Mohs surgery in Australia II. Outcome at 5-year follow-up
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Igal Leibovitch1, Shyamala C Huilgol, Dinesh Selva
1Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia.
Background:
Long-term follow-up is essential to evaluate the role of Mohs micrographic surgery (MMS) in the treatment for cutaneous basal cell carcinoma (BCC).
Objective:
Our purpose was to report the 5-year follow-up outcome of patients treated with MMS for BCC.
Method:
This prospective, multicenter case series included all patients in Australia treated with MMS for BCC, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. Parameters recorded were patient demographics, duration of tumor, site, preoperative tumor size, recurrences before MMS, histologic classification of malignancy, postoperative defect size, and 5-year recurrence after MMS.
Results:
Three thousand three hundred seventy (3370) patients (1594 female and 1776 male patients) completed a 5-year follow-up period. Fifty-six percent of the tumors were primary and 44% were previously recurrent. Most of them (98.4%) were located on the head and neck, and the most common histologic subtypes were nodulocystic (29.3%) and infiltrating (28.3%). Recurrence at 5 years was diagnosed in 1.4% of primary and in 4% of recurrent tumors. Previous tumor recurrence (P < .001), longer tumor duration before MMS (P = .015), infiltrating histology (P = .13), and more levels for tumor (P < .001) were the main predictors for tumor recurrence after MMS.
Limitation:
Data were missing for some outcome measures.
Conclusion:
The low 5-year recurrence rate of BCC with MMS emphasizes the importance of margin-controlled excision.
