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- W4366185364 abstract "Wide local excision (WLE) for melanoma in situ (MIS) of the head and neck (MISHN) is the gold-standard surgical approach. However, given the intricate anatomy of the head and neck, Mohs micrographic surgery (MMS) may provide better surgical outcomes while still ensuring adequate margin control. We compare demographics and survival of MISHN with WLE or MMS. The 2004-2019 National Cancer Database was queried for cases of MISHN and stratified by surgical type into WLE or MMS. Chi-square and t-tests were used to compare individuals between the two groups. Multivariable Cox survival analysis was used to assess for predictors of survival while controlling for confounders. We identified 45,857 patients with MISHN of which 29,006 (63.2%) receiving WLE or 16,851 (36.7%) receiving MMS. The average age of patients receiving MMS was slightly older than those receiving WLE (68.6 vs. 68.1 years, p<0.0001); 70.3% of those receiving WLE were male compared to 69.1% of those receiving MMS (p=0.0089). A greater proportion of Black patients (0.25% vs. 0.07%) received WLE (p=0.0001). There was a greater proportion of individuals in the lowest income quartile (12.4%) who received WLE compared to MMS (9.0%) (p<0.0001). Receipt of surgery was significantly different based on histology of MIS, with lentigo maligna making up a greater proportion of MMS (47.1% vs. 28.8%) whereas other subtypes made up larger proportions of WLE (p<0.0001). On multivariable survival analysis accounting for confounders, WLE had greater mortality (HR:1.137, p<0.0001). We conclude that a slight survival benefit exists when accounting for confounders for patients receiving MMS vs. WLE for excision of MISHN." @default.
- W4366185364 created "2023-04-19" @default.
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- W4366185364 date "2023-05-01" @default.
- W4366185364 modified "2023-10-01" @default.
- W4366185364 title "1285 Mohs micrographic surgery demonstrates slight survival benefit over wide local excision of melanoma in situ in the head and neck" @default.
- W4366185364 doi "https://doi.org/10.1016/j.jid.2023.03.1299" @default.
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