Surgical excision vs Mohs' micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial

Guidelines of care for the management of basal cell carcinoma

“…50 Smeets et al reported that for tumors requiring more than 1 standard excision, or at least 2 stages of MMS, defects after excision were significantly larger than after MMS for primary and recurrent BCC. 33 Although smaller defects did not lead to significant differences in aesthetic outcome between MMS and standard excision in RCTs, both surgical modalities were found to be superior to C&E with regard to quality of life outcomes. 31,33 A noteworthy limitation of MMS is that tissue blocks are not available for molecular testing or further evaluation of high-risk or unusual features by using paraffin sections.…”

“…33 Although smaller defects did not lead to significant differences in aesthetic outcome between MMS and standard excision in RCTs, both surgical modalities were found to be superior to C&E with regard to quality of life outcomes. 31,33 A noteworthy limitation of MMS is that tissue blocks are not available for molecular testing or further evaluation of high-risk or unusual features by using paraffin sections. 55 To overcome this challenge, the tumor debulk specimen may be submitted for paraffin sections to document high-risk features and obtain ancillary molecular studies, if indicated, without compromising the integrity of the MMS procedure.…”

“…The first RCT for MMS comparing MMS with standard excision of primary and recurrent facial BCC was conducted in the Netherlands. 32,33,49 In the final analysis, a 10-year recurrence rate of 4.4% was reported for primary facial BCC treated with MMS, compared with 12.2% (P = .100) following standard excision. For recurrent BCC, the 10-year recurrence rates were 3.9% and 13.5% (P = .023) after MMS and standard excision, respectively.…”

“…In the same cohort, the local recurrence rate increased to 12.2% at 10 years, with 56% of recurrences identified beyond 5 years of followup. 32,33 Despite advances in topical and systemic therapies, as well as a variety of energy devices, surgery remains the cornerstone of BCC treatment. Three surgical treatment modalities are reviewed in this section: standard excision, MMS, and C&E. Nonsurgical therapies, including radiotherapy and cryosurgery, are addressed separately.…”

Micrographic surgey for the treatment of non-melanoma skin cancers of the head and neck

“…Sonuçlar Mohs mikrografik cerrahisinin nüks açısından en düşük oranları sağladığı bilgisini 10 yıllık takipte hem primer hem de rekkürren BHK için teyit etmiştir. Oysa aynı ekip erken dönemde ve 5 yıllık takipte Mohs mikrografik cerrahisini sadece rekürren tümörlerde avantajlı tespit etmiştir 12,13 . Bu çalışmanın sonuçları BHK ile ilişkili gerçeği yansıtan nüks bilgileri için takip süresinin 5 yıl değil 10 yıl olması gerekliliğini düşündürmektedir.…”