Mohs best for high-risk cancers on face

Mohs micrographic surgery is the ideal treatment option for high-risk skin cancers occurring on the face, results of a study show.

Investigators from the University of Virginia, Charlottesville, reviewed 495 lesions that were removed with Mohs surgery from 180 male and 119 female patients between 2005 and 2011. The size and final defect size were compared to calculate the margins needed. Lesions were categorized based on their histological characteristics.

Mean margins for low-risk basal cell carcinomas (BCC) were 2.4 mm, 3.7 mm for high-risk basal cell, 2.6 mm for low-risk squamous cell (SCC) and 5.3 mm for high-risk squamous cell, according to the study abstract.

The established high-risk zones for BCC and SCC were not associated with larger margins. The margins required to excise completely 95 percent of all the low-risk BCCs, high-risk BCCs, low-risk SCCs and high-risk SCCs were 4.75 mm, 8 mm, 5 mm and 13.25 mm, respectively.

“When primary excision instead of Mohs micrographic surgery is the only option, the aforementioned margins may be considered guidelines,” the study authors noted. “The relevance of this study is to guide future management and margins for primary excision.”

The study was published online June 6 in JAMA Facial Plastic Surgery.