Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Risk Factors for Complicated Mohs Surgery in the South Sweden Mohs Cohort

Nätterdahl, Carolina ; Kappelin, Johan LU ; Persson, Bertil LU ; Lundqvist, Katarina LU ; Ahnlide, Ingela LU ; Saleh, Karim LU and Ingvar, Åsa LU orcid (2022) In Journal of the European Academy of Dermatology and Venereology 36(7). p.1113-1117
Abstract
Background: Mohs micrographic surgery (MMS) is a precise, tissue-sparing surgical technique that offers superior cure rates compared to traditional surgical excision. However, the degree of difficulty of MMS depends on many variables, and consequently, the number of surgical stages required for each case is quite unpredictable.
Objectives: To identify risk factors for complicated MMS, defined as MMS requiring ≥3 stages.
Methods: In a cohort study design, data were prospectively collected from 612 patients that underwent MMS for basal cell carcinoma (BCC) at the Department of Dermatology, Skåne University Hospital, Lund, between 2009 and 2020. Univariate and multivariate logistic regression were used to estimate the risk of MMS... (More)
Background: Mohs micrographic surgery (MMS) is a precise, tissue-sparing surgical technique that offers superior cure rates compared to traditional surgical excision. However, the degree of difficulty of MMS depends on many variables, and consequently, the number of surgical stages required for each case is quite unpredictable.
Objectives: To identify risk factors for complicated MMS, defined as MMS requiring ≥3 stages.
Methods: In a cohort study design, data were prospectively collected from 612 patients that underwent MMS for basal cell carcinoma (BCC) at the Department of Dermatology, Skåne University Hospital, Lund, between 2009 and 2020. Univariate and multivariate logistic regression were used to estimate the risk of MMS requiring ≥3 stages. Due to the risk of multicollinearity between recurrent or incompletely excised BCC and previous treatments, a partially and a fully adjusted multivariate logistic regression model were constructed.
Results: In fully adjusted multivariate analyses, age (odds ratio (OR) 1.02; confidence interval (CI) 95% 1.00-1.04), previous cryotherapy (OR 2.3; CI 95% 1.1-4.8), and >1 previous surgery (OR 3.4; CI 95% 1.5-7.7) were significantly associated with risk of complicated MMS. Recurrent BCC was associated with the risk of complicated MMS in partially adjusted multivariate analyses, but not in the fully adjusted analyses. In this highly selected cohort, histopathological subtype, and tumour localization were not associated with the risk of complicated MMS.
Conclusions: Older age and tumours previously treated with cryotherapy or multiple prior surgeries increased the risk of MMS requiring ≥3 stages. Whether recurrent BCC is an independent risk factor for complicated MMS needs further evaluation. Knowledge of these risk factors may ameliorate the planning of Mohs surgeries.
(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; and
organization
alternative title
Riskfaktorer för komplicerad Mohs kirurgi i Mohs-kohorten i södra Sverige
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Basal Cell Carcinoma, Surgery
in
Journal of the European Academy of Dermatology and Venereology
volume
36
issue
7
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:85128021030
  • pmid:35366359
ISSN
1468-3083
DOI
10.1111/jdv.18124
language
English
LU publication?
yes
id
3c2e3d3a-c846-45e4-996b-9ec50cf80bac
date added to LUP
2022-05-04 16:33:24
date last changed
2022-11-03 03:00:14
@article{3c2e3d3a-c846-45e4-996b-9ec50cf80bac,
  abstract     = {{Background: Mohs micrographic surgery (MMS) is a precise, tissue-sparing surgical technique that offers superior cure rates compared to traditional surgical excision. However, the degree of difficulty of MMS depends on many variables, and consequently, the number of surgical stages required for each case is quite unpredictable.<br/>Objectives: To identify risk factors for complicated MMS, defined as MMS requiring ≥3 stages.<br/>Methods: In a cohort study design, data were prospectively collected from 612 patients that underwent MMS for basal cell carcinoma (BCC) at the Department of Dermatology, Skåne University Hospital, Lund, between 2009 and 2020. Univariate and multivariate logistic regression were used to estimate the risk of MMS requiring ≥3 stages. Due to the risk of multicollinearity between recurrent or incompletely excised BCC and previous treatments, a partially and a fully adjusted multivariate logistic regression model were constructed.<br/>Results: In fully adjusted multivariate analyses, age (odds ratio (OR) 1.02; confidence interval (CI) 95% 1.00-1.04), previous cryotherapy (OR 2.3; CI 95% 1.1-4.8), and &gt;1 previous surgery (OR 3.4; CI 95% 1.5-7.7) were significantly associated with risk of complicated MMS. Recurrent BCC was associated with the risk of complicated MMS in partially adjusted multivariate analyses, but not in the fully adjusted analyses. In this highly selected cohort, histopathological subtype, and tumour localization were not associated with the risk of complicated MMS.<br/>Conclusions: Older age and tumours previously treated with cryotherapy or multiple prior surgeries increased the risk of MMS requiring ≥3 stages. Whether recurrent BCC is an independent risk factor for complicated MMS needs further evaluation. Knowledge of these risk factors may ameliorate the planning of Mohs surgeries.<br/>}},
  author       = {{Nätterdahl, Carolina and Kappelin, Johan and Persson, Bertil and Lundqvist, Katarina and Ahnlide, Ingela and Saleh, Karim and Ingvar, Åsa}},
  issn         = {{1468-3083}},
  keywords     = {{Basal Cell Carcinoma; Surgery}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{7}},
  pages        = {{1113--1117}},
  publisher    = {{Elsevier}},
  series       = {{Journal of the European Academy of Dermatology and Venereology}},
  title        = {{Risk Factors for Complicated Mohs Surgery in the South Sweden Mohs Cohort}},
  url          = {{http://dx.doi.org/10.1111/jdv.18124}},
  doi          = {{10.1111/jdv.18124}},
  volume       = {{36}},
  year         = {{2022}},
}