Superficial Radiation Therapy versus Mohs Micrographic Surgery: A Systematic Review and Meta-Analysis.

Area of Science:

• Dermatology
• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Limited comparative studies exist on the effectiveness of superficial radiation therapy (SRT) versus Mohs micrographic surgery (MMS) for nonmelanoma skin cancer (NMSC).
• Understanding the comparative local recurrence rates is crucial for optimizing NMSC treatment strategies.

Purpose of the Study:

• To systematically compare the local recurrence rates of NMSC treated with SRT versus MMS.
• To provide evidence-based insights into the comparative efficacy of these two common NMSC treatment modalities.

Main Methods:

• Comprehensive literature search conducted across major databases (Ovid Medline, Web of Science, Embase, CINAHL) up to November 2024.
• Inclusion of case series, cohort studies, chart reviews, and randomized controlled trials.
• Meta-analysis performed using a random-effects model to calculate weighted local recurrence rates for both SRT and MMS.

Main Results:

• Analysis included 9 studies (7,809 NMSC cases) for SRT and 17 studies (10,247 NMSC cases) for MMS.
• Mohs micrographic surgery demonstrated significantly lower local recurrence rates (1.9%) compared to superficial radiation therapy (6.3%).
• Subgroup analysis revealed a statistically significant difference in local recurrence rates between MMS and SRT (-12%, p = .0013).

Conclusions:

• Systematic review and meta-analysis indicate that Mohs micrographic surgery is associated with a lower local recurrence rate for nonmelanoma skin cancer than superficial radiation therapy.
• Findings suggest Mohs micrographic surgery may be a more effective treatment option for reducing NMSC recurrence.