Melanoma of the Face and Mohs Micrographic Surgery: Nationwide Mortality Data Analysis

Dermatol Surg. 2018 Apr;44(4):481-492. doi: 10.1097/DSS.0000000000001429.

Abstract

Background: Although Mohs micrographic surgery (MMS), narrow margin excision (NME), and wide margin excision (WME) are commonly used to treat melanoma of the face, there is a paucity of data comparing mortality outcomes for each method.

Objective: To determine the association between surgical method used to treat cutaneous melanoma of the face and patient survival.

Materials and methods: A retrospective review of Surveillance, Epidemiology, and End Results registries for patients diagnosed with melanoma of the face between 2003 and 2012 was conducted.

Results: The authors query resulted in 43,443 records. Patients with melanoma were more likely to undergo NME (57.79%) than WME (27.86%) or MMS (14.36%). Overall 5-year risk of death was higher with WME (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.00-1.23; p = .043) and NME (HR, 1.10; 95% CI, 1.00-1.20; p = .046) relative to MMS after adjusting for patient demographics, residence socioeconomic factors, and tumor characteristics. No statistically significant difference in melanoma-specific mortality was found between different surgical methods on multivariate analysis.

Conclusion: Patients with melanoma of the face treated with MMS had similar melanoma-specific mortality or overall survival outcome as patients treated by other surgical modalities.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Facial Neoplasms / mortality*
  • Facial Neoplasms / surgery*
  • Female
  • Humans
  • Male
  • Margins of Excision
  • Melanoma / mortality*
  • Melanoma / surgery*
  • Middle Aged
  • Mohs Surgery
  • Retrospective Studies
  • SEER Program
  • Skin Neoplasms / mortality*
  • Skin Neoplasms / surgery*
  • Survival Rate
  • United States