Defining recurrence of nonmelanoma skin cancer after Mohs micrographic surgery: Report of the American College of Mohs Surgery Registry and Outcomes Committee

J Am Acad Dermatol. 2016 Nov;75(5):1022-1031. doi: 10.1016/j.jaad.2016.06.047. Epub 2016 Aug 18.

Abstract

Background: Standardized definitions and methods of surveillance for local recurrence of nonmelanoma skin cancer are critical in determining cure rates attributed to treatment modalities.

Objective: We sought to offer a standard definition of local recurrence after surgical treatment of nonmelanoma skin cancer and to propose an acceptable surveillance period and tracking methods.

Methods: A literature search was performed for background definitions of local recurrence and tracking methods. The American College of Mohs Surgery (ACMS) Registry and Outcomes Committee then conducted a modified Delphi process to arrive at consensus definitions.

Results: We define local recurrence as a tumor with comparable histology, with contiguity to the surgical scar after treatment, and that arises within the area of the previously treated tumor.

Limitations: This project reports the results of a modified Delphi method process involving members of the ACMS. The model described may not be useful for nonexcision type treatments such as topical chemotherapy, electrodessication and curettage, or radiation treatment.

Conclusions: Previous definitions of recurrence and surveillance methods after surgical treatment of nonmelanoma skin cancer are variable and nonstandard. We describe consensus standards for defining and tracking recurrence that should allow for consistent scientific evaluation and development of performance data in skin cancer outcomes registries.

Keywords: Mohs micrographic surgery; basal cell carcinoma; local recurrence; outcomes; recurrence; registry; squamous cell carcinoma; surveillance.

Publication types

  • Case Reports

MeSH terms

  • Algorithms
  • Carcinoma, Basal Cell / diagnosis*
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Cicatrix / pathology
  • Consensus
  • Delphi Technique
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Margins of Excision
  • Models, Theoretical
  • Mohs Surgery*
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasms, Second Primary / diagnosis
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery
  • Software Design
  • Treatment Outcome