Mohs Micrographic Surgery May Up Survival in Stage I Melanoma

Mohs micrographic surgery (MMS) is associated with improved survival compared with traditional surgery with wide margin excision (WME) for stage I melanoma, according to a study published online in JAMA Dermatology.

Shayan Cheraghlou, from Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a retrospective cohort study to examine overall survival of patients with stage I melanoma defined by the American Joint Committee on Cancer Cancer Staging Manual, 8th edition after MMS versus WME. Data were included for 70,319 eligible patients with a diagnosis from Jan. 1, 2004, through Dec. 31, 2014: 67,085 treated with WME and 3,234 treated with MMS.

The researchers found that treatment with MMS correlated with a modest improvement in overall survival compared with WME in an analysis controlling for clinical and tumor factors (hazard ratio, 0.86). Survival was modestly improved in a propensity score-matched analysis of cohorts of MMS-treated versus WME-treated patients (hazard ratio, 0.82). Compared with nonacademic facilities, academic facilities were more likely to use MMS (odds ratio, 2.03).

"My hope is that this finding will challenge all of us who treat melanoma, regardless of specialty, to come together to more rigorously study treatments and strive to maximize outcomes for our patients," writes the author of an accompanying editorial.

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