Recent findings further support the use of Mohs micrographic surgery (MMS) for treatment of melanoma of the head and neck. Researchers aimed to describe a novel treatment algorithm for the surgical management of head and neck melanoma and compare rates of local recurrence for tumors treated with either MMS using immunohistochemistry or wide local excision (WLE). They conducted a 10-year retrospective chart review including all in situ and invasive melanomas of the head and neck treated at one institution from January 2004 to June 2013. They found:
- Among 388 patients with melanoma, MMS was associated with decreased rates of local recurrence.
- However, patient and tumor characteristics varied significantly, and WLE subgroup was largely composed of higher stage and risk tumors.
- Subgroup analysis found that patients with in situ or thin invasive tumors (<0.8 mm) treated with MMS had improved local recurrence outcomes, despite more frequent tumor location on high risk anatomic sites (eg, central face).
- In addition, MMS was associated with a favorable delay in time to local recurrence among in situ tumors (HR=31.8).
Demer AM, Vance KK, Cheraghi N, Reich HC, Lee PK. Benefit of Mohs micrographic surgery over wide local excision for melanoma of the head and neck: A rational approach to treatment. [Published online ahead of print December 13, 2018]. Dermatolog Surg. doi:10.1097/DSS.0000000000001715.