Risk Factors and Rate of Recurrence after Mohs Surgery in Basal Cell and Squamous Cell Carcinomas: A Nationwide Prospective Cohort (REGESMOHS, Spanish Registry of Mohs Surgery)

• Published in: Acta dermato-venereologica 2021-11, Vol.101 (11), p.adv00602-adv00602
• Main Authors: Tomás-Velázquez, Alejandra, Sanmartin-Jiménez, Onofre, Garcés, Joan R., Rodríguez-Prieto, Manuel A., Ruiz-Salas, Verónica, De Eusebio-Murillo, Esther, Miñano-Medrano, Román, Escutia-Muñoz, Begoña, Flórez-Menéndez, Ángeles, Artola-Igarza, Juan L., Alfaro-Rubio, Alberto, Gil, Pilar, Delgado-Jiménez, Yolanda, Sanchez-Schmidt, Julia M., Allende-Markixana, Irati, Alonso-Pacheco, María L., García-Bracamonte, Beatriz, De la Cueva-Dobao, Pablo, Navarro-Tejedor, Raquel, Ciudad-Blanco, Cristina, Carnero-González, Lucía, Vázquez-Veiga, Hugo, Cano-Martínez, Natividad, Vilarrasa-Rull, Eva, Sanchez-Sambucety, Pedro, López-Estebaranz, José L., Botella-Estrada, Rafael, Gonzalez-Sixto, Beatriz, Martorell-Calatayud, Antonio, Morales-Gordillo, Victoriano, Toll-Abelló, Agustí, Ocerin-Guerra, Izascun, Mayor-Arenal, Matías, Suárez-Fernández, Ricardo, Sainz-Gaspar, Laura, Descalzo, Miguel A., García-Doval, Ignacio, Redondo, Pedro
• Format: Article
• Language: English
• Subjects: basal cell carcinoma; Investigative Report; Mohs surgery; recurrence; risk factors; squamous cell carcinoma
• ISSN: 0001-5555; 1651-2057
• DOI: 10.2340/actadv.v101.544

Randomized studies to assess the efficacy of Mohs micrographic surgery in basal cell and squamous cell carcinomas are limited by methodological and ethical issues and a lack of long follow-up periods. This study presents the “real-life” results of a nationwide 7-years cohort on basal cell carcinoma and squamous cell carcinoma treated with Mohs micrographic surgery. A prospective cohort was conducted in 22 Spanish centres (from July 2013 to February 2020) and a multivariate analysis, including characteristics of patients, tumours, surgeries and follow-up, was performed. A total of 4,402 patients followed up for 12,111 patient-years for basal cell carcinoma, and 371 patients with 915 patient-years of follow-up for squamous cell carcinoma were recruited. Risk factors for recurrence included age, non-primary tumours and more stages or unfinished surgeries for both tumours, and immunosuppression for squamous cell carcinoma. Incidence rates of recurrence were 1.3 per 100 person-years for basal cell carcinoma (95% confidence interval 1.1–1.5) and 4.5 for squamous cell carcinoma (95% confidence interval 3.3–6.1), being constant over time (0–5 years). In conclusion, follow-up strategies should be equally intense for at least the first 5 years, with special attention paid to squamous cell carcinoma (especially in immunosuppressed patients), elderly patients, non-primary tumours, and those procedures requiring more stages, or unfinished surgeries.