Application Of Mohs Micrographic Surgery Appropriate-use Criteria To Skin Cancers At A University Health System | 46817
Journal of Cancer Science & Therapy
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Skin cancer is the most common type of cancer in the United States and various countries around the world. Mohs micrographic
surgery (MMS) is an effective treatment for skin cancer but one of many treatments that can be used. Until recently, it has been
difficult to determine the percentage of skin cancers best treated with MMS. The appropriate-use criteria were developed by the
American Academy of Dermatology in 2012 as a consensus of expert opinion and represent an opportunity to more accurately
estimate this number. We sought to apply the appropriate-use criteria retrospectively to University of Virginia Health System skin
cancers so as to determine the proportion that met appropriate use within 8 months. A list of all biopsy-proven skin cancers, excluding
invasive melanoma, at the University of Virginia Health System during an 8-month period was generated. Patient and tumor data
were collected retrospectively from hospital records and each skin cancer was classified as appropriate, inappropriate, or uncertain
based on the appropriate-use criteria. Among 1059 skin cancers, MMS was appropriate in 72.0% of cases, inappropriate in 20.4%, and
uncertain in 7.6%. Altogether, 59.3% of skin cancers occurred in H and M areas, which include the head, neck, hands, feet, ankles,
genitalia, nipples/areola, and pretibial surface. These results provide insight into the potential demand for MMS at this institution but
also other academic institutions.