WEDNESDAY, Feb. 19, 2025 -- For treatment of primary high-stage cutaneous squamous cell carcinoma (cSCC), Mohs surgery is associated with improved outcomes compared with wide-lesion excision (WLE), according to a study published online Feb. 19 in JAMA Dermatology.

David M. Wang, M.D., from Brigham and Women's Hospital in Boston, and colleagues examined the outcomes of primary high-stage cSCC among patients treated with Mohs surgery versus WLE in a retrospective cohort study using propensity score weighting. The study included 216 patients with high-stage cSCC (mean age, 73.5 years), with a median follow-up of 33.1 months.

The researchers found that in the inverse probability of treatment weighting competing risk model, the three-year cumulative incidence of all adverse outcomes was greater among patients in the WLE group versus the Mohs surgery group, including local recurrence, nodal metastasis, distant metastasis, any recurrence, and disease-specific death (weighted cause-specific hazard ratios, 2.33, 1.80, 2.10, 2.38, and 2.74, respectively).

"The findings of this cohort study suggest that Mohs surgery may be superior to WLE for the treatment of high-stage cSCC," the authors write. "The propensity score-weighted analysis demonstrated a halving of three-year cumulative incidence of recurrence, metastasis, and disease-specific death for tumors treated with Mohs surgery compared with WLE."

Several authors disclosed ties to the biopharmaceutical industry.