Study Helps Define Skin Cancer Excisional Margins
Last Updated: 2013-06-14 16:16:22 -0400 (Reuters Health)
By David Douglas
NEW YORK (Reuters Health) - When Mohs surgery is not available, the findings of a new review may help guide primary excision in patients with nonmelonoma skin cancer of the face.
"Excisional margins for cutaneous malignancies remain ambiguous. This review looks at margins as defined by Mohs surgery and provides suggestions for excision based on histologic features. More aggressive excision may be needed to reduce recurrence rates," Dr. Stephen S. Park told Reuters Health by email.
Mohs micrographic surgery (MMS) involves examining 100% of the surgical margins in three dimensions, thus maximizing complete tumor removal while preserving as much normal surrounding tissue as possible.
In a June 6 online paper in JAMA Facial Plastic Surgery, Dr. Park and colleagues at the University of Virginia in Charlottesville reported on 302 patients whose 495 lesions were managed with Mohs surgery.
In reviewing their data, they assumed that the final defect after MMS contains an adequate margin for definitive treatment.
The mean margins for low-risk basal cell carcinomas were 2.4 mm and for high risk, 3.7 mm. For low-risk squamous cell carcinomas, they were 2.6 mm and for high risk, 5.3 mm.
Based on these data, the team established that corresponding margins required to completely excise 95% of all these carcinomas were 4.75 mm, 8 mm, 5 mm, and 13.25 mm.
Thus they conclude that even for low-risk lesions, margins should be a minimum of 5 mm, and high risk lesions require margins closer to 1 cm.
SOURCE: http://bit.ly/120VKNU
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