Non-Melanoma Skin Cancer Treated with Mohs
Micrographic Surgery in Thailand
Piyaroj Sethabutra MD1, Rungsima Wanitphakdeedecha MD, MA, MSc1, Sasima Eimpunth MD1,
Woraphong Manuskiatti MD1
Affiliation :
1 Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Long-term follow-up, complications, and patient satisfaction are essential outcome measures regarding the bene(cid:976)its
of Mohs micrographic surgery [MMS] for treating non-melanoma skin cancers [NMSCs].
Objective : To report risk factors, clinical (cid:976)indings, and follow-up outcomes of all NMSC patients treated with MMS.
Materials and Methods: The present retrospective study included all patients in the outpatient Dermatology Clinic of Siriraj
Hospital, Bangkok, Thailand, with NMSC treated with MMS between 2008 and 2013. The outcomes measured were patient
demographic data, duration of tumor, recurrence of tumor before MMS, number of lesions, risk factors for developing skin cancer,
histological type and subtype, location of tumor, pre-operative and post-operative size, method of closure, operative time, 5-year
recurrence rate after MMS, complications, and patient satisfaction.
Results : The present study included 108 patients (63% females and 37% males) with a mean age of 70±12 years (range 36 to 93
years). The mean duration of tumor was 37±60 months (range 0.5 to 480 months). Basal cell carcinoma [BCC] comprised 95.1% of
cases, whereas squamous cell carcinoma [SCC] was 4.9%. The signi(cid:976)icant risk factor for both BCC and SCC was sun exposure. The
most common locations for both BCC and SCC were the head and neck regions. The most common subtype for BCC was a non-aggressive
subtype, 47%. The most commonly used method of closure was second intention, 28 cases (22.8%). The mean operative time was
116.13 minutes (range: 30 to 360 minutes). During the longest follow-up time (60 months), the recurrence rate was 0.81%. There
were no major complications. The majority (96.4%) of patients gave a 75% to 100% satisfaction rate after surgery.
Conclusion : The present study demonstrates less than one percent recurrence rate in NMSCs treated with MMS and the necessity
of margin control in high-risk tumors.
Keywords : Non-melanoma skin cancer, Mohs micrographic surgery
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