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Establishment of a Clinic-based Biorepository
Published on: May 29, 2017
Cost effectiveness of Mohs micrographic surgery
1Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. rstern@bidmc.harvard.edu
The Journal of Investigative Dermatology
|April 19, 2013
Summary
Mohs micrographic surgery (MMS) shows modestly better recurrence rates for facial nonmelanoma skin cancers compared to excision. Physician skill is crucial, and evidence-based guidelines are needed to justify MMS
Area of Science:
- Dermatology
- Surgical Oncology
Background:
- Nonmelanoma skin cancers (NMSCs) are common.
- Mohs micrographic surgery (MMS) use has increased significantly.
- MMS is more costly than standard excision surgery.
Purpose of the Study:
- To compare recurrence rates of MMS versus excision for primary facial NMSCs.
- To evaluate the cost-effectiveness of MMS.
- To identify clinical circumstances where MMS benefits outweigh costs.
Main Methods:
- Comparative analysis of recurrence rates.
- Review of cost data for MMS and excision.
- Assessment of physician skill's impact on outcomes.
Main Results:
- MMS demonstrated modestly lower recurrence rates than excision for facial NMSCs.
- The cost of MMS has risen substantially, exceeding two billion dollars annually.
- Physician skill appears to be a critical factor in surgical outcomes, potentially as important as the surgical technique itself.
Conclusions:
- While MMS may offer a modest benefit in recurrence rates for facial NMSCs, its higher cost requires careful consideration.
- The skill of the surgeon is a significant determinant of success for both MMS and excision.
- There is a need for evidence-based guidelines to help clinicians and patients decide when the increased cost of MMS is justified.
