Practice habits of Mohs surgeons treating melanoma with Mohs surgery: A cross-sectional survey

Siscos, Spyros M.; Neill, Brett C.; Seger, Edward W.; Rajpara, Anand; Hocker, Thomas L.

doi:10.1016/j.jaad.2020.09.081

Cited by 7 publications

(11 citation statements)

References 4 publications

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“…Consistent with survey 7,8 and claims data, 2 published reports of MMS for melanoma show variations in indications and surgical techniques for MMS for melanoma. Mohs surgeons differ in the use of MMS for invasive melanoma, excise different sized margins on the first MMS layer, and use varying techniques to process tissue, determine tumor stage, and assess microscopic margins.…”

Section: Discussionsupporting

confidence: 57%

“…Mohs surgeons vary in techniques to assess MMS margins, including the use of IHC and whether to excise an additional peripheral margin for permanent sections after MMS. Similar to survey data, 7,8 a majority (67%, 16/24) of centers evaluate margins with IHC, 10,12,14,15,17–25,27,28,32 most commonly with MART-1. Frozen sections with melanocytic IHC detect melanoma as accurately as permanent sections, 47,50 have a higher sensitivity and specificity for detecting melanoma compared with H&E stains, 51,52 and may result in fewer stages and simpler reconstruction.…”

Section: Discussionmentioning

confidence: 57%

“…2 Survey data also indicate that Mohs surgeons use MMS for melanoma for different indications and with varied technique. 7,8…”

mentioning

confidence: 99%

“…2 Survey data also indicate that Mohs surgeons use MMS for melanoma for different indications and with varied technique. 7,8 Because 50.0% of surveyed Mohs surgeons completed fellowships that did not perform MMS for melanoma, 7 new adopters may use protocols from published reports of MMS for melanoma as a template for their practices. Variations in published techniques may promote nonuniform outcomes for MMS for melanoma.…”

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confidence: 99%

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Systematic Review of Technical Variations for Mohs Micrographic Surgery for Melanoma

et al. 2021

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BACKGROUND Mohs micrographic surgery (MMS) for cutaneous melanoma is becoming more prevalent, but surgical technique varies. OBJECTIVE To define variations in published techniques for MMS for melanoma. METHODS AND MATERIALS A systematic review was performed of PubMed, EMBASE, and Scopus databases to identify all articles describing surgical techniques for MMS for melanoma. Technical details were recorded for the preoperative, intraoperative, and postoperative phases of MMS. RESULTS Twenty-four articles were included. Mohs surgeons vary in how they assess clinical margins, how wide a margin they excise on the first MMS layer, and how they process tissue to determine tumor stage and margin clearance during MMS for melanoma. CONCLUSION Mohs micrographic surgery for melanoma is performed with varied surgical techniques. To establish best practices, additional research is necessary to determine how different techniques affect outcomes.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 57%

“…2 Survey data also indicate that Mohs surgeons use MMS for melanoma for different indications and with varied technique. 7,8…”

mentioning

confidence: 99%

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confidence: 99%

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Systematic Review of Technical Variations for Mohs Micrographic Surgery for Melanoma

et al. 2021

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“…8 However, only a minority of Mohs surgeons treat melanoma with MMS. [9][10][11][12][13][14][15] Given that general dermatologists play a vital role in treating and referring patients with melanoma, this nationwide cross-sectional survey sought to investigate the practice habits and referral preferences of general dermatologists regarding MMS for treating melanoma on the head and neck.…”

mentioning

confidence: 99%

Factors Influencing General Dermatologists When Referring Patients With Head and Neck Melanoma for Mohs Micrographic Surgery: A Nationwide Cross-Sectional Survey

et al. 2023

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BACKGROUNDMohs micrographic surgery (MMS) for cutaneous melanoma has demonstrated higher cure rates, lower local recurrence rates, and improved survival compared with wide local excision (WLE). However, factors affecting referrals by general dermatologists for MMS of head and neck melanoma (HNM) are unknown.OBJECTIVETo elucidate referral factors and treatment perspectives of general dermatologists regarding MMS for melanoma in situ (MIS)/lentigo maligna (LM) and early-stage melanoma on the head and neck.MATERIALS AND METHODSA cross-sectional analysis was performed using survey responses of general dermatologists with membership in the American Academy of Dermatology.RESULTSA total of 231 and 132 of the 402 responding general dermatologists routinely referred melanoma in situ MIS/LM and early invasive melanoma for MMS, respectively. Lack of local access to a Mohs surgeon was the most common deterring reason for MIS/LM referral to MMS, whereas the preference for WLE was the most common deterring reason for early invasive melanoma.CONCLUSIONLack of local access to a Mohs surgeon treating HNM with MMS is the primary barrier in referrals to Mohs surgeons for MIS and LM. Among general dermatologists, WLE is preferred for early invasive HNM.

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Mohs micrographic surgery in the surgical treatment paradigm of melanoma in situ and invasive melanoma: A clinical review of treatment efficacy and ongoing controversies

Shah,

Trepanowski,

Grant-Kels

et al. 2024

Journal of the American Academy of Dermatology

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Practice habits of Mohs surgeons treating melanoma with Mohs surgery: A cross-sectional survey

Cited by 7 publications

References 4 publications

Systematic Review of Technical Variations for Mohs Micrographic Surgery for Melanoma

Systematic Review of Technical Variations for Mohs Micrographic Surgery for Melanoma

Factors Influencing General Dermatologists When Referring Patients With Head and Neck Melanoma for Mohs Micrographic Surgery: A Nationwide Cross-Sectional Survey

Mohs micrographic surgery in the surgical treatment paradigm of melanoma in situ and invasive melanoma: A clinical review of treatment efficacy and ongoing controversies

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