BACKGROUND: Mohs micrographic surgery (MMS) represents a promising option for treatment of melanoma in situ (MIS). However, interpretation of melanocytic lesions by fresh frozen sections may be difficult. OBJECTIVE: The objective of this study was to determine if margins called clear by MMS were clear by subsequent paraffin-embedded sections and to compare cure rate with available data for MMS and standard excision. MATERIALS AND METHODS: A total of 167 patients with MIS, including 116 patients with MIS in sun-exposed skin of lentigo maligna (LM) type, were treated by MMS with subsequent evaluation of the final margin with paraffin-embedded sections that were cut en face, over a period of 12 years. A total of 143 patients were available for follow-up from 6 months to 12 years (mean, 50 months; median 48 months; 594.5 patient-years), and 109 patients were available for follow-up from 2 to 12 years (mean, 63 months; median, 60 months; 569 patient-years). RESULTS: The clearance rate by MMS technique using frozen sections was 94.1% for MIS non-LM type, 95.7% for MIS LM type, and 95.1% for both. The cure rate was 97.8% for MIS non-LM type, 99.0% for MIS LM type, and 98.6% for both for mean follow-up of 50 months and 97.4% for MIS non-LM type, 98.6% for MIS LM type, and 98.2% for both for mean follow-up of 63 months. CONCLUSION: MMS is a viable option for treatment of MIS that may increase cure rate and reduce the size of the defect especially in cosmetically and functionally sensitive areas.
BACKGROUND: Mohs micrographic surgery (MMS) represents a promising option for treatment of melanoma in situ (MIS). However, interpretation of melanocytic lesions by fresh frozen sections may be difficult. OBJECTIVE: The objective of this study was to determine if margins called clear by MMS were clear by subsequent paraffin-embedded sections and to compare cure rate with available data for MMS and standard excision. MATERIALS AND METHODS: A total of 167 patients with MIS, including 116 patients with MIS in sun-exposed skin of lentigo maligna (LM) type, were treated by MMS with subsequent evaluation of the final margin with paraffin-embedded sections that were cut en face, over a period of 12 years. A total of 143 patients were available for follow-up from 6 months to 12 years (mean, 50 months; median 48 months; 594.5 patient-years), and 109 patients were available for follow-up from 2 to 12 years (mean, 63 months; median, 60 months; 569 patient-years). RESULTS: The clearance rate by MMS technique using frozen sections was 94.1% for MIS non-LM type, 95.7% for MIS LM type, and 95.1% for both. The cure rate was 97.8% for MIS non-LM type, 99.0% for MIS LM type, and 98.6% for both for mean follow-up of 50 months and 97.4% for MIS non-LM type, 98.6% for MIS LM type, and 98.2% for both for mean follow-up of 63 months. CONCLUSION: MMS is a viable option for treatment of MIS that may increase cure rate and reduce the size of the defect especially in cosmetically and functionally sensitive areas.
Authors: Adi Nosrati; Jacqueline G Berliner; Shilpa Goel; Joseph McGuire; Vera Morhenn; Juliana R de Souza; Yildiray Yeniay; Rasnik Singh; Kristina Lee; Mio Nakamura; Rachel R Wu; Ann Griffin; Barbara Grimes; Eleni Linos; Mary Margaret Chren; Roy Grekin; Maria L Wei Journal: JAMA Dermatol Date: 2017-05-01 Impact factor: 10.282
Authors: Joshua B Wilson; Hobart W Walling; Richard K Scupham; Andrew K Bean; Roger I Ceilley; Kirsten E Goetz Journal: J Clin Aesthet Dermatol Date: 2016-06-01
Authors: Lynn Dengel; Kristin Turza; Mary-Margaret B Noland; James W Patterson; Craig L Slingluff Journal: Ann Surg Oncol Date: 2008-09-12 Impact factor: 5.344
Authors: Kenneth M Joyce; Cormac W Joyce; Deirdre M Jones; Paul Donnellan; Alan J Hussey; Padraic J Regan; Jack L Kelly Journal: Plast Reconstr Surg Glob Open Date: 2015-03-06