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Ten Years of Scalp Keratinocyte Carcinomas (Basal Cell Carcinomas and Squamous Cell Carcinomas) Treated by Mohs
Raaisa Islam1,2, Chelsea Jones1,3, Thomas Stewart4
1The Skin Hospital, Darlinghurst, New South Wales, Australia.
Background:
There is a paucity of data on scalp keratinocyte carcinomas (KCs) referred for Mohs micrographic surgery (MMS). This study aimed to perform a descriptive analysis of scalp KCs-specifically basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs)-treated with MMS at The Skin Hospital in Sydney, Australia.
Methods:
We performed a retrospective analysis of all scalp KCs treated with MMS from October 2012 to September 2022 from an electronic database. Extracted data included age, sex, tumour histology and aggressiveness, anatomical location, preoperative tumour size, final defect size, number of MMS stages and sections, extensive subclinical spread and repair method.
Results:
We identified 1177 scalp KCs treated with MMS in 889 patients, consisting of 948 BCCs (80.5%) and 229 SCCs (19.5%). The median age of patients with BCCs was significantly younger (60 years) than that of SCCs (73 years) (p < 0.001). SCCs were more commonly found in males (182/229, 79%) (p < 0.001). The majority of KCs were located on the frontal scalp (948/1177, 55%). BCCs were more likely to be of an aggressive subtype (58%, 512/876) than SCCs (21%, 44/212) (p < 0.001). The median largest tumour and defect diameter was larger for SCCs than for BCCs (p < 0.001). There was no significant difference in the median number of MMS stages for tumour type (p = 0.121). Extensive subclinical spread was more common for aggressive SCCs (13/44, 29.5%) than for BCCs (84/511, 16.4%) (p = 0.028). Primary closure repair was most common (55%, 644/1177).
Conclusion:
The observed differences in patient, tumour and treatment characteristics may help inform clinical practice and inspire further research.
Insights
This study analyzed scalp keratinocyte carcinomas (KCs) treated with Mohs micrographic surgery (MMS), finding differences in basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) patient and tumor characteristics. These findings can inform clinical practice for scalp cancer treatment.
Area of Science:
- Dermatology
- Surgical Oncology
- Oncology
Background:
- Limited data exists on scalp keratinocyte carcinomas (KCs) undergoing Mohs micrographic surgery (MMS).
- This study addresses the paucity of information by analyzing scalp KCs treated with MMS.
Purpose of the Study:
- To perform a descriptive analysis of scalp basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) treated with MMS.
- To characterize patient demographics, tumor histology, and treatment details for scalp KCs.
Main Methods:
- Retrospective analysis of scalp KCs treated with MMS from October 2012 to September 2022.
- Data extraction included patient age, sex, tumor type and aggressiveness, location, size, MMS stages, subclinical spread, and repair method.
Main Results:
- 1177 scalp KCs (948 BCCs, 229 SCCs) were analyzed in 889 patients.
- BCCs occurred in younger patients (median 60 years) than SCCs (median 73 years).
- Aggressive BCC subtypes were more common (58%) than aggressive SCCs (21%), with SCCs showing larger defect sizes and more frequent subclinical spread.
Conclusions:
- Significant differences exist in patient and tumor characteristics between scalp BCCs and SCCs treated with MMS.
- Findings may guide clinical practice and stimulate further research in scalp cancer management.
