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Published on: February 12, 2022
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Factors to Predict 13 or More Sections in Mohs Micrographic Surgery.
Gilberto Moreno Bonilla1,2, Vendula Blaya-Novakova3, Thomas Jonathan Stewart1
1The Skin Hospital, Westmead, New South Wales, Australia.
The Australasian Journal of Dermatology
|December 31, 2025
Summary
Predictors for requiring numerous Mohs micrographic surgery (MMS) sections were identified. Largest tumor diameter, recurrence, mixed histology, and patient age are key factors influencing the number of MMS sections needed.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Previous studies focused on predicting Mohs micrographic surgery (MMS) stages.
- Predictors for the number of sections required during MMS have not been previously analyzed.
Purpose of the Study:
- To identify factors predicting the need for 13 or more sections during Mohs micrographic surgery (MMS).
- To analyze patient, tumor, management, and practitioner-related factors associated with extensive MMS procedures.
Main Methods:
- Retrospective case-control study of keratinocyte cancer (KC) patients (2013-2017).
- Univariate logistic regression and multivariate predictive modeling were used to analyze predictive factors.
- Tumor and defect surface areas were secondary outcomes.
Main Results:
- 1.9% of 10,132 MMS procedures required more than 13 sections.
- Significant predictors for >13 MMS sections included largest preoperative tumor diameter, mixed histology, tumor recurrence, and patient age (AUC 88.4%).
- Cases requiring more sections had significantly larger defects compared to controls (median tumor to defect ratio 3.94 vs. 2.43).
Conclusions:
- Preoperative identification of factors predicting extensive MMS section requirements is possible.
- This information can aid Mohs surgeons in patient counseling and resource allocation.
