Application of Mohs micrographic surgery appropriate-use criteria to skin cancers at a university health system

作者：Blechman Adam B; Patterson James W; Russell Mark A^*

来源：Journal of the American Academy of Dermatology, 2014, 71(1): 29-35.

DOI：10.1016/j.jaad.2014.02.025

• appropriate-use criteria
• Mohs micrographic surgery
• skin cancer

Background: Mohs micrographic surgery (MMS) is an effective treatment for skin cancer. Until recently, it has been difficult to determine the percentage of skin cancers best treated with MMS. The appropriate-use criteria represents an opportunity to more accurately estimate this number.
Objective: We sought to apply the appropriate-use criteria retrospectively to University of Virginia Health System skin cancers so as to determine the proportion that met appropriate use within 8 months.
Methods: A list of all biopsy-proven skin cancers, excluding invasive melanoma, at the University of Virginia Health System during an 8-month period was generated. Patient and tumor data were collected retrospectively from hospital records and each skin cancer was classified as appropriate, inappropriate, or uncertain based on the appropriate-use criteria.
Results: Among 1059 skin cancers, MMS was appropriate in 72.0% of cases, inappropriate in 20.4%, and uncertain in 7.6%. Altogether, 59.3% of skin cancers occurred in H and M areas, which include the head, neck, hands, feet, ankles, genitalia, nipples/areola, and pretibial surface.
Limitations: Patient and tumor information was collected retrospectively at 1 institution.
Conclusions: Using recently published appropriate-use criteria, 72.0% of skin cancers at this institution were appropriate for MMS. Tumor location was the most important factor in determining appropriate use.

• 出版日期2014-7