Application of Mohs micrographic surgery appropriate-use criteria to skin cancers at a university health system.

Abstract

BACKGROUND:

Mohs micrographic surgery (MMS) is an effective treatment for skin cancer. Until recently, it has been difficult to determine the percentage of skin cancers best treated with MMS. The appropriate-use criteria represents an opportunity to more accurately estimate this number.

OBJECTIVE:

We sought to apply the appropriate-use criteria retrospectively to University of Virginia Health System skin cancers so as to determine the proportion that met appropriate use within 8 months.

METHODS:

A list of all biopsy-proven skin cancers, excluding invasive melanoma, at the University of Virginia Health System during an 8-month period was generated. Patient and tumor data were collected retrospectively from hospital records and each skin cancer was classified as appropriate, inappropriate, or uncertain based on the appropriate-use criteria.

RESULTS:

Among 1059 skin cancers, MMS was appropriate in 72.0% of cases, inappropriate in 20.4%, and uncertain in 7.6%. Altogether, 59.3% of skin cancers occurred in H and M areas, which include the head, neck, hands, feet, ankles, genitalia, nipples/areola, and pretibial surface.

LIMITATIONS:

Patient and tumor information was collected retrospectively at 1 institution.

CONCLUSIONS:

Using recently published appropriate-use criteria, 72.0% of skin cancers at this institution were appropriate for MMS. Tumor location was the most important factor in determining appropriate use.

• Authors: Adam B Blechman, James W Patterson, Mark A Russell
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 71 Issue 1 Pg. 29-35 (Jul 2014) ISSN: 1097-6787 [Electronic] United States
• PMID: 24813300 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Topics

• Academic Medical Centers
• Carcinoma in Situ (pathology, surgery)
• Carcinoma, Basal Cell (pathology, surgery)
• Carcinoma, Squamous Cell (pathology, surgery)
• Dermatology (standards)
• Facial Neoplasms (pathology, surgery)
• Head and Neck Neoplasms (pathology, surgery)
• Humans
• Mohs Surgery (standards, statistics & numerical data)
• Patient Selection
• Practice Guidelines as Topic
• Retrospective Studies
• Skin Neoplasms (pathology, surgery)
• Squamous Cell Carcinoma of Head and Neck
• Virginia