Affiliation:
1. Department of Dermatology, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota;
2. Mayo Clinic College of Medicine and Science, Library-Public Services, Mayo Clinic, Rochester, Minnesota;
3. Department of Dermatology, Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota
Abstract
BACKGROUND
Current consensus guidelines have discouraged the use of sub-0.5-cm (in situ) and sub-1-cm (invasive) margins when performing Mohs micrographic surgery (Mohs) for melanoma, with minimal evidence to guide this recommendation.
OBJECTIVE
To compare melanoma local recurrence rates after Mohs based on initial margin size.
MATERIALS AND METHODS
A systematic review and meta-analysis was conducted with search terms including Mohs micrographic surgery, surgical margin, recurrent disease, and melanoma.
RESULTS
Forty-three studies were included. The 5- to 10-mm margin category had a statistically significant lower local recurrence compared with 1- to 5-mm and 5-mm categories. Recurrence for 1- to 5-mm, 5-mm, 5- to 10-mm, and 10-mm categories were 2.3% (CI 0.8–3.5, p < .001), 1.4% (CI 0.6–2.2, p < .001), 0.3% (CI 0.2–0.5, p < .001), and 6.1% (CI -6.7 - 18.8, p = .349), respectively. Number of stages for 1 to 5, 5, 5 to 10, and 10-mm categories were 1.8, 1.8, 1.6, and 1.6, respectively. There was no statistically significant difference between the groups (p = .694).
CONCLUSION
Five- to 10-mm margins were associated with the lowest local recurrence rates. A 5- to 10-mm initial margin should be considered where other factors (tumor characteristics, anatomical or functional considerations) allow.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Dermatology,General Medicine,Surgery
Reference13 articles.
1. 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 SurgeryEpub 2012 sep 5. Erratum in;Hoc Task Force;J Am Acad Dermatolj Am Acad Dermatol,2015
2. Guidelines of care for the management of primary cutaneous melanoma;Swetter;J Am Acad Dermatol,2019
3. Local recurrence of melanoma is higher after wide local excision versus Mohs micrographic surgery or staged excision: a systematic review and meta-analysis;Pride;Dermatol Surg,2022
4. Systematic review and meta-analysis of local recurrence rates of head and neck cutaneous melanomas after wide local excision, Mohs micrographic surgery, or staged excision;Bittar;J Am Acad Dermatol,2021
5. Systematic review of technical variations for Mohs micrographic surgery for melanoma;Krausz;Dermatol Surg,2021
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