PMID- 35596540
OWN - NLM
STAT- MEDLINE
DCOM- 20220928
LR  - 20220928
IS  - 1365-2230 (Electronic)
IS  - 0307-6938 (Linking)
VI  - 47
IP  - 10
DP  - 2022 Oct
TI  - A review of the evidence for Mohs micrographic surgery. Part 2: basal cell 
      carcinoma.
PG  - 1794-1804
LID - 10.1111/ced.15266 [doi]
AB  - Mohs micrographic surgery (MMS) is considered the gold-standard treatment for 
      basal cell carcinoma (BCC) particularly for sites with a high-risk of incomplete 
      excision such as the central face, for tumours with an aggressive growth pattern 
      and consequent unpredictable subclinical extension and for recurrent tumours. 
      However, the process is more time-consuming than for standard excision (SE), and 
      the magnitude of benefit is uncertain. This article aims to provide a more 
      complete picture of current evidence, including a review of cosmetic outcomes, 
      tissue-sparing ability and cost-effectiveness of MMS. Although robust evidence is 
      lacking, there is a large volume of observational data supporting a low 
      recurrence rate after MMS. The risk of incomplete excision and higher recurrence 
      rate of standard excision favours the use of MMS at high-risk sites. There is 
      some low-certainty evidence that MMS results in a smaller defect size compared 
      with SE, and that incomplete excision with SE results in larger defects. Larger 
      defects may affect cosmetic outcome but there is no direct evidence that MMS 
      improves cosmetic outcome compared with SE. There is conflicting evidence 
      regarding the cost of MMS compared with SE, as some studies consider MMS less 
      expensive than SE and others consider it more expensive, which may reflect the 
      healthcare setting. A multicentre 10-year randomized controlled trial comparing 
      MMS and SE in the treatment of high-risk BCC would be desirable, but is unlikely 
      to be feasible or ethical. Collection of robust registry data capturing both MMS 
      and SE outcomes would provide additional long-term outcomes.
CI  - (c) 2022 British Association of Dermatologists.
FAU - Brown, Alistair C
AU  - Brown AC
AUID- ORCID: 0000-0003-2707-968X
AD  - The Skin Centre, Tauranga, New Zealand.
FAU - Brindley, Luke
AU  - Brindley L
AD  - Department of Dermatology, Walsall Healthcare NHS Trust, Walsall, UK.
FAU - Hunt, William T N
AU  - Hunt WTN
AD  - Department of Dermatology, Derriford Hospital, University Hospitals Plymouth NHS 
      Trust, Plymouth, UK.
FAU - Earp, Eleanor M
AU  - Earp EM
AUID- ORCID: 0000-0002-8316-0223
AD  - Department of Dermatology, Chalmers Hospital, NHS Lothian, Edinburgh, UK.
FAU - Veitch, David
AU  - Veitch D
AD  - Department of Dermatology, Leicester Royal Infirmary, University Hospitals 
      Leicester NHS Trust, Leicester, UK.
FAU - Mortimer, Neil J
AU  - Mortimer NJ
AD  - The Skin Centre, Tauranga, New Zealand.
FAU - Salmon, Paul J M
AU  - Salmon PJM
AD  - The Skin Centre, Tauranga, New Zealand.
FAU - Wernham, Aaron
AU  - Wernham A
AUID- ORCID: 0000-0001-5920-6888
AD  - Department of Dermatology, Walsall Healthcare NHS Trust, Walsall, UK.
AD  - Department of Dermatology, Leicester Royal Infirmary, University Hospitals 
      Leicester NHS Trust, Leicester, UK.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220712
PL  - England
TA  - Clin Exp Dermatol
JT  - Clinical and experimental dermatology
JID - 7606847
SB  - IM
MH  - *Carcinoma, Basal Cell/pathology/surgery
MH  - *Facial Neoplasms/pathology
MH  - Humans
MH  - Mohs Surgery/methods
MH  - Multicenter Studies as Topic
MH  - Neoplasm Recurrence, Local
MH  - Randomized Controlled Trials as Topic
MH  - *Skin Neoplasms/pathology/surgery
MH  - Treatment Outcome
EDAT- 2022/05/22 06:00
MHDA- 2022/09/28 06:00
CRDT- 2022/05/21 01:52
PHST- 2022/05/17 00:00 [accepted]
PHST- 2022/05/22 06:00 [pubmed]
PHST- 2022/09/28 06:00 [medline]
PHST- 2022/05/21 01:52 [entrez]
AID - 10.1111/ced.15266 [doi]
PST - ppublish
SO  - Clin Exp Dermatol. 2022 Oct;47(10):1794-1804. doi: 10.1111/ced.15266. Epub 2022 
      Jul 12.