Surgery For Nonmelanoma Skin Cancer Research Articles

Use of Ex Vivo Confocal Scanning Laser Microscopy during Mohs Surgery for Nonmelanoma Skin Cancers

Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs surgery. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. One-hundred fifteen Stage I Mohs surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs surgery.

Use of Ex Vivo Confocal Scanning Laser Microscopy during Mohs Surgery for Nonmelanoma Skin Cancers

BACKGROUND Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs surgery. OBJECTIVE The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. METHODS One-hundred fifteen Stage I Mohs surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. RESULTS Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. CONCLUSION Ex vivo confocal scanning laser microscopy can potentially expedite Mohs surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs surgery.

Prognostic factors for life expectancy in nonagenarians with nonmelanoma skin cancer: Implications for selecting surgical candidates

Background: Controversy exists over surgical intervention for nonmelanoma skin cancer in the very elderly. Objective: We sought to define variables that are prognostic for survival in the elderly after surgery for skin cancer. Methods: We reviewed 99 charts of nonagenarians who had Mohs micrographic surgery for nonmelanoma skin cancer and recorded data on comorbid conditions and date of death. Comorbid conditions were quantified by the Charlson index. Results: Patients with Charlson scores of zero (no comorbidities) had a statistically significant longer survival than patients with Charlson scores of ≥3 (multiple comorbidities). Women survived longer than men at both 1 and 5 years. No patient died within 30 days of operation. Conclusion: Charlson scores of ≥3 in nonagenarians predict shorter survival. Although this parameter may predict shorter survival when skin cancer surgery is considered in a cohort of elderly patients, it remains difficult to predict accurately the survival of individual patients with scores ≥3. (J Am Acad Dermatol 2002;47:419-22.)

Use of alternative therapies by patients undergoing surgery for nonmelanoma skin cancer.

The use of alternative therapies is becoming increasingly common and may result in unwanted side effects and drug interactions. To determine the frequency of alternative medicine use by patients undergoing Mohs surgery for nonmelanoma skin cancer. A written survey concerning use of alternative therapies was given to patients undergoing Mohs surgery for nonmelanoma skin cancer. A follow-up telephone survey was used to clarify positive responses. Thirty-six of 192 (18.8%) patients with nonmelanoma skin cancer reported using some type of alternative therapy. Almost all patients were using these therapies for conditions unrelated to their nonmelanoma skin cancer. Herbs and botanicals were the most common type of alternative therapy utilized. Physicians performing Mohs surgery should be aware that a significant number of their patients use alternative therapies. Since most patients do not readily volunteer information about alternative medicine usage, specific steps should be taken to obtain this information.

Use of Alternative Therapies by Patients Undergoing Surgery for Nonmelanoma Skin Cancer

Use of Alternative Therapies by Patients Undergoing Surgery for Nonmelanoma Skin Cancer

Mohs' micrographic surgery for nonmelanoma skin cancers

Mohs' micrographic surgery for nonmelanoma skin cancers

Mohs' micrographic surgery for nonmelanoma skin cancers: Nelson BR, Railan D, Cohen S. Clin Plast Surg 24:705, 1997

Mohs' micrographic surgery for nonmelanoma skin cancers: Nelson BR, Railan D, Cohen S. Clin Plast Surg 24:705, 1997

Mohs micrographic surgery for nonmelanoma skin cancer

Mohs micrographic surgery for nonmelanoma skin cancer

Wound Healing after Lower Leg Radiotherapy

X-ray radiotherapy is a good alternative to surgery for selected nonmelanoma skin cancer of the head and neck region. Radiotherapy is used less frequently for lesions on the trunk and extremities because of concerns about adverse acute and chronic radiation effects. In this British retrospective study, investigators compared wound healing of lower leg lesions after …