Postoperative Defect Size as a Criterion for Upstaging High-Risk Cutaneous Squamous Cell Carcinoma Treated With Mohs Micrographic Surgery.

IF 2.2 3区医学 Q2 DERMATOLOGY

Dermatologic Surgery Pub Date : 2025-10-01 Epub Date: 2025-06-04 DOI:10.1097/DSS.0000000000004720

Vijay Kodumudi, Amanda Rosenthal, Geena Conde, Margit Juhasz, Nima Gharavi

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引用次数: 0

Abstract

Background: Brigham and Women's Hospital (BWH) criteria classify cutaneous squamous cell carcinoma (cSCC) with a preoperative (clinical) size ≥2 cm as high risk. However, the role of postoperative defect (histologic) size after Mohs micrographic surgery (MMS) in cSCC staging remains unclear.

Objective: To compare outcomes of cSCCs treated with MMS that have a clinical size <2 cm but a histologic size ≥2 cm with those clinically ≥2 cm.

Methods: Data were collected at a tertiary academic center. Patients with cSCC were followed for at least 33 months postoperatively. Recurrence, nodal involvement, metastasis, and disease-specific mortality were collectively analyzed as poor outcomes using multivariable logistic regression.

Results: Among 517 cSCCs, 216 were clinically ≥2 cm, and 301 were histologically ≥2 cm. Univariate analysis showed no significant differences between histologically ≥2 cm and clinically ≥2 cm cSCCs in recurrence or lymph node spread, although histologically ≥2 cm cSCCs were less frequently associated with disease-specific death ( p = .010) and metastasis ( p = .042). Multivariable logistic regression demonstrated that tumors histologically ≥2 cm did not have a significant difference in poor outcomes compared to those clinically ≥2 cm (OR [95% CI] = 0.37 [0.15-1.39]).

Conclusion: Postoperative defect size after MMS is a valid parameter for cSCC upstaging using BWH criteria.

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术后缺损大小作为Mohs显微手术治疗高危皮肤鳞状细胞癌的标准。

背景：布里格姆妇女医院（BWH）的标准将术前（临床）尺寸≥2cm的皮肤鳞状细胞癌（cSCC）归为高危。然而，Mohs显微手术（MMS）术后缺损（组织学）大小在cSCC分期中的作用尚不清楚。目的：比较具有临床规模的MMS治疗cSCCs的结果方法：数据收集于某三级学术中心。术后随访cSCC患者至少33个月。复发、淋巴结受累、转移和疾病特异性死亡率均采用多变量logistic回归分析为不良结果。结果：517例cSCCs中，216例临床≥2cm， 301例组织学≥2cm。单因素分析显示，组织学≥2 cm和临床≥2 cm的cSCCs在复发或淋巴结扩散方面无显著差异，尽管组织学≥2 cm的cSCCs与疾病特异性死亡（p = 0.010）和转移（p = 0.042）的相关性较低。多变量logistic回归显示，组织学≥2 cm的肿瘤与临床≥2 cm的肿瘤相比，预后不良无显著差异（OR [95% CI] = 0.37[0.15-1.39]）。结论：MMS术后缺损大小是采用BWH标准诊断cSCC的有效参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.