Abstract
The objective of this study was to quantitatively compare outcomes between standard excision (SE) and Mohs micrographic surgery (MMS) for basal cell carcinoma (BCC). A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and a search of electronic databases was conducted to identify all randomised controlled trials (RCTs) and observational studies comparing the outcomes of SE versus MMS for BCC. The primary outcome was the recurrence rate for primary and recurrent BCC. The secondary outcomes included the cost of treatment, aesthetic results, the rate of incomplete excision, and the surgical defect size post excision. Five studies enrolling 2060 lesions were identified. There was a statistically significant difference between MMS and SE groups in terms of recurrence rate for primary BCCs (odds ratio (OR) = 0.44, confidence interval (CI) = 0.16 to 0.97, P = 0.04) and recurrent BCCs (OR = 0.33, CI = 0.12 to 0.97, P = 0.04). For secondary outcomes, MMS had improved results compared with SE, except for mean cost. In conclusion, both primary and secondary BCCs treated with MMS have a reduced recurrence rate and defect size thus simplifying reconstruction. However, due to higher costs and operative time attributed to MMS, it should be reserved for high-risk BCCs.
Highlights
BackgroundBasal cell carcinoma (BCC) is the most common type of skin cancer across most parts of the world and the single leading cause of cancer among Caucasians [1]
Outcomes for basal cell carcinoma (BCC) treated by standard excision (SE) and Mohs micrographic surgery (MMS) in the head and neck have been compared in randomised controlled trials (RCTs) as well as observational studies including the rate of carcinoma recurrence [5,9,10,11,12,13]
There was a statistically significant difference seen in the odds ratios analysis (OR) showing significantly fewer recurrence rates in primary lesions treated by MMS (OR= 0.27, confidence intervals (CIs) = 0.15 to 0.46, P ≤ 0.00001)
Summary
BackgroundBasal cell carcinoma (BCC) is the most common type of skin cancer across most parts of the world and the single leading cause of cancer among Caucasians [1]. After the lesion has been excised using SE, the specimen is sliced vertically, like a loaf of bread, and analysed [7]. This only gives an account of less than 2% of the specimen’s margin, [7]. Obtaining greater accuracy of the extent of the lesion’s margins provides better surgical clearance leading to lower recurrence rates [8]. Outcomes for BCCs treated by SE and MMS in the head and neck have been compared in randomised controlled trials (RCTs) as well as observational studies including the rate of carcinoma recurrence [5,9,10,11,12,13]. This study will be the first in the literature to report on this subject
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
