Skip to main content

Advertisement

Log in

Mohs Micrographic Surgery for Treatment of Non-melanoma Skin Cancer

  • HEAD & NECK: Non-melanoma Skin Cancer of the Head and Neck (J Moyer, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The aims of this report are to review literature supporting the use of Mohs micrographic surgery for treatment of non-melanoma skin cancer and to address indications and potential limitations of this form of therapy for non-melanoma skin cancer.

Recent Findings

The first randomized controlled trial comparing standard excision to Mohs micrographic surgery for treatment of facial basal cell carcinoma has recently been published, demonstrating a lower recurrence rate after Mohs surgery compared to standard excision after a 5-year and 10-year follow-up period, supporting its use in the treatment of high-risk basal cell skin cancer.

Summary

Mohs micrographic surgery is indicated for treatment of basal cell carcinomas and cutaneous squamous cell carcinomas at high risk of recurrence and for tumors located in areas where tissue conservation and/or functional preservation is desired.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the U.S. population, 2012. JAMA Dermatol. 2015;151(10):1081–6. https://doi.org/10.1001/jamadermatol.2015.1187.

    Article  PubMed  Google Scholar 

  2. Kim C, Cheng J, Colegio OR. Cutaneous squamous cell carcinomas in solid organ transplant recipients: emerging strategies for surveillance, staging, and treatment. Semin Oncol. 2016;43(3):390–4. https://doi.org/10.1053/j.seminoncol.2016.02.019.

    Article  PubMed  CAS  Google Scholar 

  3. Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol. 2012;166(5):1069–80. https://doi.org/10.1111/j.1365-2133.2012.10830.x.

    Article  PubMed  CAS  Google Scholar 

  4. Miller DL, Weinstock MA. Nonmelanoma skin cancer in the United States: incidence. J Am Acad Dermatol. 1994;30(5 Pt 1):774–8.

    Article  PubMed  CAS  Google Scholar 

  5. Alam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med. 2001;344(13):975–83. https://doi.org/10.1056/NEJM200103293441306.

    Article  PubMed  CAS  Google Scholar 

  6. Chren MM, Sahay AP, Bertenthal DS, Sen S, Landefeld CS. Quality-of-life outcomes of treatments for cutaneous basal cell carcinoma and squamous cell carcinoma. J Investig Dermatol. 2007;127(6):1351–7. https://doi.org/10.1038/sj.jid.5700740.

    Article  PubMed  CAS  Google Scholar 

  7. Rowe DE, Carroll RJ, Day CL Jr. Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. J Dermatol Surg Oncol. 1989;15(3):315–28.

    Article  PubMed  CAS  Google Scholar 

  8. Mohs FE. Microscopically guided excision of cancer of the skin by means of chemosurgery. J Ark Med Soc. 1968;65(6):203–9.

    PubMed  CAS  Google Scholar 

  9. Swanson NA. Mohs surgery. Technique, indications, applications, and the future. Arch Dermatol. 1983;119(9):761–73.

    Article  PubMed  CAS  Google Scholar 

  10. Shriner DL, McCoy DK, Goldberg DJ, Wagner RF Jr. Mohs micrographic surgery. J Am Acad Dermatol. 1998;39(1):79–97.

    Article  PubMed  CAS  Google Scholar 

  11. Rowe DE, Carroll RJ, Day CL Jr. Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol. 1989;15(4):424–31.

    Article  PubMed  CAS  Google Scholar 

  12. Ad Hoc Task F, Connolly SM, Baker DR, Coldiron BM, Fazio MJ, Storrs PA, et al. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol. 2012;67(4):531–50. https://doi.org/10.1016/j.jaad.2012.06.009.

    Article  Google Scholar 

  13. • van Loo E, Mosterd K, Krekels GA, Roozeboom MH, Ostertag JU, Dirksen CD, et al. Surgical excision versus Mohs’ micrographic surgery for basal cell carcinoma of the face: a randomised clinical trial with 10 year follow-up. Eur J Cancer. 2014;50(17):3011–20. https://doi.org/10.1016/j.ejca.2014.08.018. This was the first randomized controlled trial evaluating Mohs versus standard excision which demonstrated a significantly lower recurrence rate for high-risk facial basal cell carcinoma treated with Mohs micrographic surgery compared to standard excision after a 10-year follow-up period.

    Article  PubMed  Google Scholar 

  14. Muller FM, Dawe RS, Moseley H, Fleming CJ. Randomized comparison of Mohs micrographic surgery and surgical excision for small nodular basal cell carcinoma: tissue-sparing outcome. Dermatol Surg. 2009;35(9):1349–54. https://doi.org/10.1111/j.1524-4725.2009.01240.x.

    Article  PubMed  CAS  Google Scholar 

  15. Smeets NW, Krekels GA, Ostertag JU, Essers BA, Dirksen CD, Nieman FH, et al. Surgical excision vs Mohs’ micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial. Lancet. 2004;364(9447):1766–72. https://doi.org/10.1016/S0140-6736(04)17399-6.

    Article  PubMed  Google Scholar 

  16. NCCN Clinical Practice Guidelines in Oncology: Basal Cell Skin Cancer. Version I.2018.

  17. Mora RG, Robins P. Basal-cell carcinomas in the center of the face: special diagnostic, prognostic, and therapeutic considerations. J Dermatol Surg Oncol. 1978;4(4):315–21.

    Article  PubMed  CAS  Google Scholar 

  18. NCCN Clinical Practice Guidelines in Oncology: Squamous Cell Skin Cancer. Version 2. 2018.

  19. Ebede TL, Lee EH, Dusza SW, Busam KJ, Nehal KS. Clinical value of paraffin sections in association with Mohs micrographic surgery for nonmelanoma skin cancers. Dermatol Surg. 2012;38(10):1631–8. https://doi.org/10.1111/j.1524-4725.2012.02570.x.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alison B. Durham.

Ethics declarations

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on HEAD & NECK: Non-melanoma Skin Cancer of the Head and Neck

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Quintanilla-Dieck, J., Bichakjian, C.K. & Durham, A.B. Mohs Micrographic Surgery for Treatment of Non-melanoma Skin Cancer. Curr Otorhinolaryngol Rep 6, 115–119 (2018). https://doi.org/10.1007/s40136-018-0193-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40136-018-0193-5

Keywords

Navigation