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<p>Cutaneous melanoma is rising in incidence and can lead to significant morbidity and mortality. Its surgical management is primarily via wide local excision (WLE), however, recent studies have suggested equal or greater outcomes when utilizing Mohs micrographic surgery (MMS). Our retrospective cohort study using the SEER database aimed to investigate differences in outcomes of invasive cutaneous melanomas treated via MMS and WLE. Melanoma-in-situ and distant-stage disease were excluded and analyses were performed using SPSS v29.0. Among 92,557 identified cases, WLE was used in 91.1% and MMS in 8.9%, with MMS more commonly being used in the head/neck sites (53.9% vs. 19.1%) and localized disease (95.9% vs. 85.5%; both <i>p</i> &lt; 0.001). Multivariate cox regression, adjusted for age, sex, race/ethnicity, rural-urban residence, income, stage, subtype, site, and Breslow thickness, revealed WLE was independently associated with higher DSS mortality (aHR 1.17; 95% CI 1.01–1.36; p=0.041). These findings suggest a potential DSS advantage for MMS over WLE in CM management, warranting prospective studies to better investigate this question.</p>

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Improved disease-specific outcomes in invasive cutaneous melanomas treated with Mohs surgery compared to wide local excision

  • 期刊论文

  • 发表日期：

    2026年7月11日

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  • Divya Sharma,
  • Mitchell A. Taylor,
  • Sierra Thomas,
  • Aaron Farberg,
  • Vanessa B. Voss

摘要

Cutaneous melanoma is rising in incidence and can lead to significant morbidity and mortality. Its surgical management is primarily via wide local excision (WLE), however, recent studies have suggested equal or greater outcomes when utilizing Mohs micrographic surgery (MMS). Our retrospective cohort study using the SEER database aimed to investigate differences in outcomes of invasive cutaneous melanomas treated via MMS and WLE. Melanoma-in-situ and distant-stage disease were excluded and analyses were performed using SPSS v29.0. Among 92,557 identified cases, WLE was used in 91.1% and MMS in 8.9%, with MMS more commonly being used in the head/neck sites (53.9% vs. 19.1%) and localized disease (95.9% vs. 85.5%; both p < 0.001). Multivariate cox regression, adjusted for age, sex, race/ethnicity, rural-urban residence, income, stage, subtype, site, and Breslow thickness, revealed WLE was independently associated with higher DSS mortality (aHR 1.17; 95% CI 1.01–1.36; p=0.041). These findings suggest a potential DSS advantage for MMS over WLE in CM management, warranting prospective studies to better investigate this question.