Long-term outcomes of Mohs micrographic surgery for invasive melanoma of the trunk and proximal portion of the extremities

Abstract

Microscopicevaluation of the entire surgical margin during excision of cutaneous malignancies results in the highest rates of complete excision and lowest rates of true local scar recurrence. Few studies demonstrate the outcomes of Mohs micrographic surgery specifically for invasive melanoma of the trunk and proximalportion of the extremities. To evaluate the long-term efficacy of Mohs micrographic surgery for invasive melanoma of the trunk and proximal portion of the extremities, including true local scar recurrence rate, distant recurrence-free survival, and disease-specific survival. Prospectively collected study of 1416 cases of invasive melanoma of the trunk and proximal portion of the extremities was performed to evaluate long-term outcomes. True local scar recurrences occurred in our cohort at a rate of 0.14% (2/1416), after a mean follow-up period of 75months and were not associated with tumor depth. Therate of satellite/in-transit recurrences and the disease-specific survival stratified by tumor thickness were superior to historical control values. We used a nonrandomized, single institution, retrospective design. Mohsmicrographic surgery of primary cutaneous invasive melanoma on the trunk andproximal portion of the extremities resulted in local control of 99.86% of tumors and an overalldisease-specific death rate superior to that of wide local excision.