Adam B Blechman1, James W Patterson2, Mark A Russell3. 1. Department of Dermatology, University of Virginia Health System, Charlottesville, Virginia. 2. Department of Dermatology, University of Virginia Health System, Charlottesville, Virginia; Department of Pathology, University of Virginia Health System, Charlottesville, Virginia. 3. Department of Dermatology, University of Virginia Health System, Charlottesville, Virginia. Electronic address: Mr2h@virginia.edu.
Abstract
BACKGROUND: Mohs micrographic surgery (MMS) is an effective treatment for skin cancer. Until recently, it has been difficult to determine the percentage of skin cancers best treated with MMS. The appropriate-use criteria represents an opportunity to more accurately estimate this number. OBJECTIVE: We sought to apply the appropriate-use criteria retrospectively to University of Virginia Health System skin cancers so as to determine the proportion that met appropriate use within 8 months. METHODS: A list of all biopsy-proven skin cancers, excluding invasive melanoma, at the University of Virginia Health System during an 8-month period was generated. Patient and tumor data were collected retrospectively from hospital records and each skin cancer was classified as appropriate, inappropriate, or uncertain based on the appropriate-use criteria. RESULTS: Among 1059 skin cancers, MMS was appropriate in 72.0% of cases, inappropriate in 20.4%, and uncertain in 7.6%. Altogether, 59.3% of skin cancers occurred in H and M areas, which include the head, neck, hands, feet, ankles, genitalia, nipples/areola, and pretibial surface. LIMITATIONS: Patient and tumor information was collected retrospectively at 1 institution. CONCLUSIONS: Using recently published appropriate-use criteria, 72.0% of skin cancers at this institution were appropriate for MMS. Tumor location was the most important factor in determining appropriate use.
BACKGROUND: Mohs micrographic surgery (MMS) is an effective treatment for skin cancer. Until recently, it has been difficult to determine the percentage of skin cancers best treated with MMS. The appropriate-use criteria represents an opportunity to more accurately estimate this number. OBJECTIVE: We sought to apply the appropriate-use criteria retrospectively to University of Virginia Health System skin cancers so as to determine the proportion that met appropriate use within 8 months. METHODS: A list of all biopsy-proven skin cancers, excluding invasive melanoma, at the University of Virginia Health System during an 8-month period was generated. Patient and tumor data were collected retrospectively from hospital records and each skin cancer was classified as appropriate, inappropriate, or uncertain based on the appropriate-use criteria. RESULTS: Among 1059 skin cancers, MMS was appropriate in 72.0% of cases, inappropriate in 20.4%, and uncertain in 7.6%. Altogether, 59.3% of skin cancers occurred in H and M areas, which include the head, neck, hands, feet, ankles, genitalia, nipples/areola, and pretibial surface. LIMITATIONS: Patient and tumor information was collected retrospectively at 1 institution. CONCLUSIONS: Using recently published appropriate-use criteria, 72.0% of skin cancers at this institution were appropriate for MMS. Tumor location was the most important factor in determining appropriate use.
Authors: Sarah E Stuart; Patrick Schoen; Chengshi Jin; Rupa Parvataneni; Sarah Arron; Eleni Linos; W John Boscardin; Mary-Margaret Chren Journal: J Am Acad Dermatol Date: 2017-03-29 Impact factor: 11.527