How patient and tumor factors influence clearance margins and the number of Mohs Micrographic Surgery (MMS) stages when treating basal cell carcinoma (BCC) remains widely uncharacterized. It is important to elucidate these relationships, as surgical outcomes may be compared nationally between colleagues. Our objective is to evaluate the relationships between defect size and patient demographics, as well as between BCC subtypes and the number of MMS stages. Our second objective is to compare practice patterns and characteristics of patients requiring MMS at academic centers and private practices. A retrospective chart review was performed using data collected at academic centers (2015–2018) and private practices (2011–2018) of BCC patients older than 18 years old who underwent MMS. In total, 7651 patients with BCC requiring MMS were identified. Academic center adjusted analyses demonstrated clearance margins 0.1 mm higher for every year’s increase in age (p< 0.0001) and 0.25 increase in MMS stages for high-risk BCC (p< 0.0001). Private practice adjusted analyses demonstrated clearance margins 0.04 mm higher for every year’s increase in age (p< 0.0001). Clearance margins correlate with older age, and additional MMS stages correlate with high-risk BCC, suggesting the role patient and tumor factors may play in predicting tumor clearance and MMS stages.
患者与肿瘤因素如何影响基底细胞癌（BCC）治疗中的安全切缘及莫氏显微描记手术（MMS）阶段数，目前仍缺乏明确特征。阐明这些关系至关重要，因为手术结果可在全国范围内进行同行比较。本研究旨在评估缺损大小与患者人口学特征之间的关系，以及BCC亚型与MMS阶段数之间的关联。第二个目标是比较学术中心与私人诊所中需接受MMS治疗患者的临床实践模式及特征。研究通过回顾性病历分析，纳入2015-2018年学术中心及2011-2018年私人诊所中接受MMS治疗的18岁以上BCC患者数据。共纳入7651例需行MMS的BCC患者。学术中心的校正分析显示：年龄每增加1岁，安全切缘扩大0.1毫米（p<0.0001）；高危BCC的MMS阶段数增加0.25个（p<0.0001）。私人诊所的校正分析表明：年龄每增加1岁，安全切缘扩大0.04毫米（p<0.0001）。安全切缘与高龄相关，额外MMS阶段数与高危BCC相关，提示患者与肿瘤因素可能对预测肿瘤清除效果及MMS阶段数具有重要参考价值。
肿瘤(癌症)患者之家