Retrospective cohort study of Mohs surgery versus wide local excision in primary high-stage cutaneous squamous cell carcinoma

Patients with high-stage cutaneous squamous cell carcinoma (cSCC) are at risk for recurrence, metastasis, and mortality. A retrospective cohort study at Brigham and Women’s Hospital (Boston, MA) compared outcomes after Mohs surgery versus wide local excision (WLE) for high-stage cSCC. In this study including 216 patients, Mohs surgery (n=131) compared with WLE (n=85) was associated with improved 3-year cumulative incidences of local recurrence, nodal metastasis, distant metastasis, any recurrence, and disease-specific death. The authors conclude that patients with primary high-stage cSCC should be offered first-line treatment with Mohs surgery or alternative methods of peripheral and deep en face margin assessment whenever possible.