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Previous therapy and the recurrence rate of basal cell carcinoma after Mohs surgery: a meta-analysis

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Abstract

Mohs micrographic surgery (MMS) for basal cell carcinoma (BCC) is indicated for patients at high risk of recurrence; other therapies, including standard surgical excision, cryotherapy, electrodesiccation and curettage, and radiotherapy, are used in low-risk BCC and in patients who cannot undergo surgery. However, in the case of recurrence following treatment with any of these methods, MMS is indicated. This study aimed to examine how preoperative treatment before MMS affects the recurrence rate after surgery. We conducted a meta-analysis to compare the recurrence rates of primary BCC and previously treated BCC in patients undergoing MMS, with a 5-year follow-up. The secondary outcomes were the recurrence rate after MMS based on previous radiation therapy status, mean time to recurrence, and number of cases undergoing more than one stage of MMS. The recurrence rate in the previously treated group was 2.44 times greater than that of the primary BCC group. In the previous treatment group, the patients who underwent previous radiation showed a 2.52-fold higher recurrence rate than those with no previous radiation therapy. However, there was no significant difference in the mean time to recurrence and the number of cases requiring MMS > 1 stage between the previously treated and non-treated groups. Patients with previously treated BCC, especially those treated using radiation, had a higher likelihood of recurrence.

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Data /Code availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

Data Availability

The datasets supporting the conclusions of this article are available in the supplementary file 1.

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Acknowledgements

We have received inspiration from Assoc. Prof. Dr. Nopadon Noppakun for this research topic. This meta-analysis could not have been accomplished without the kindness of Dr. Somkiat Potisat and Associate Professor Dr. Pojai Pattanittum, who provided critical suggestions for improvement of the manuscript. Moreover, we would like to thank Editage (www.editage.com) for careful English language editing.

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Authors and Affiliations

  1. Department of Medical Services, Institute of Dermatology, Phayathai, Bangkok, 10400, Thailand

    Apasee Sooksamran, Pitchayasak Pichai, Mingkwan Suphannaphong & Sasathorn Singthong

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  1. Apasee Sooksamran
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Contributions

AS generated the research question and the outline of this meta-analysis. PP was involved in the research methodology and statistical analysis. MS and SS contributed to the study selection and abstract screening. SS wrote the introduction section of this paper. All authors commented on previous versions of the manuscript and have read and approved the final manuscript.

Corresponding author

Correspondence to Apasee Sooksamran.

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Conflict of interest

Apasee Sooksamran, Pitchayasak Pichai, Mingkwan Wichaidit, and Sasathorn Singthong declare that they have no conflict of interest.

Ethics approval

The study design was expedited by the appropriate ethics review board, Institutional Review Board of the Institute of Dermatology IRB/IEB038/2564, because this systematic review uses publicly accessible documents not involving in patient privacy.

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Sooksamran, A., Pichai, P., Suphannaphong, M. et al. Previous therapy and the recurrence rate of basal cell carcinoma after Mohs surgery: a meta-analysis. Arch Dermatol Res 315, 1747–1754 (2023). https://doi.org/10.1007/s00403-023-02558-w

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