For patients with high-risk cutaneous squamous cell carcinoma (cSCC), Mohs micrographic surgery (MMS) yields high five-year disease-specific survival, local recurrence (LR)-free survival, and regional/distant metastasis-free survival, according to research published online June 24 in the Journal of the American Academy of Dermatology.

Teo Soleymani, M.D., from the David Geffen School of Medicine at the University of California in Los Angeles, and colleagues examined the clinical outcomes of high-risk cSCCs treated with MMS alone in terms of LR, nodal metastasis (NM), distant metastasis, and disease-specific death in a retrospective review of high-risk cSCC patients treated from Jan. 1, 2000, to Jan. 1, 2020. A total of 581 high-risk primary cSCCs were identified in 527 patients; follow-up data were available for 579 tumors.

The researchers found that the mean survival time was 18.6 years, with five-year disease-specific survival of 95.7 percent. Five-year LR-free survival, regional NM-free survival, and DM-free survival was 96.9, 93.8, and 97.3, respectively. Progression-free survival from metastatic disease was 92.6 and 90.0 percent, respectively, at five- and 10-years. The two-year disease-specific survival was 90.5 percent for patients who experienced regional nodal metastases and underwent salvage head and neck dissection ± radiation.

"By improving local tumor control, MMS appears to reduce the frequency of regional metastatic disease and may confer a survival advantage even for those patients who develop regional nodal metastases, as evidenced by our postsalvage disease-specific survival outcomes," the authors write.

Abstract/Full Text