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Can Mohs Appropriate Use Criteria Score Help Determine Keratinocyte Carcinoma Treatment?

Mohs micrographic surgery was only done on 32.3 percent of the keratinocyte carcinomas that qualified based on AUC score

By Dermsquared Editorial Team | November 15, 2023

WEDNESDAY, Nov. 15, 2023 -- The Mohs appropriate use criteria (AUC) score can help to ascertain whether a keratinocyte carcinoma (KC) warrants Mohs micrographic surgery (MMS), according to a review published in the November issue of SKIN.

Richard H. Hope, M.D., from Texas Tech University Sciences Center in Lubbock, and colleagues conducted a retrospective review of 11,145 consecutive KCs between January 2017 and December 2021 to stratify KC by treatment modality and compare the associated Mohs AUC score with the treatment modality.

The researchers found that the average Mohs AUC score was 7.1 for all KCs combined, with 78.2 percent of the KCs qualifying for MMS via AUC score. However, only 32.3 percent of KCs underwent MMS. Of the KCs, excisional surgery was used to treat 41.1 percent; 24.9 percent were treated with electrodesiccation and curettage (ED&C), and 6.6 percent were treated with biopsy only. Overall, 70.7, 70.7, and 72.4 percent of those KCs treated with excision, ED&C, or biopsy, respectively, reached an "appropriate" Mohs AUC sore for MMS.

"We can determine that just because a KC reaches the Mohs AUC score for MMS does not necessarily mean that MMS is the best treatment option for that particular patient and tumor based on the patient's clinical status and the clinician's evaluation [of] the lesion," the authors write.


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