Photo Credit: Marco VDM
The following is a summary of “How dermatologic surgeons decide to proceed with surgery for nonmelanoma skin cancer when site identification is initially uncertain: A nationwide, multicenter, prospective study,” published in the September 2024 issue of Dermatology by Ahmed et al.
Researchers conducted a retrospective study to estimate the frequency and characterize the management of skin cancer treated by surgery when the anatomic location of the tumor was uncertain.
They included 17,076 nonmelanoma skin cancer cases from 22 academic and private Mohs micrographic surgery centers. The study focused on cases with uncertain tumor sites (i.e., the lesion site was in question), and relevant data was gathered in an online database. A lesion in question (LIQ) was defined as one with uncertain or incomplete site information from all available sources.
The results showed 98 (0.60%) of 17,076 cases had uncertain tumor sites, with a higher frequency in older male patients and those biopsied over 30 days ago. Surgeons used an average of 5.0 (95% CI: 4.61-5.39) additional methods to confirm site location, including re-checking documentation (92%), expanded physical exams (91%), and asking the patient to point with a mirror (62%). Photographs were requested in 15%, and frozen section biopsies in another 15%. In 10%, the referring physician was contacted. Surgeons successfully identified the correct site in 82% (80 of 98) of cases, while 18% (18 of 98) were postponed, mostly at non-facial sites.
Investigators concluded the dermatologic surgeons employ various methods to pinpoint tumor location when it’s uncertain, sometimes leading to procedure postponements.
Source: sciencedirect.com/science/article/abs/pii/S0190962224028731
