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The following is a summary of “Mohs Micrographic Surgery Versus Wide Local Excision in the Treatment of Anogenital Squamous Cell Carcinoma: A Systematic Review,” published in the February 2025 issue of International Journal of Dermatology by Yadlapati et al. 

Primary anogenital squamous cell carcinoma (SCC), a locally aggressive malignancy, necessitated careful surgical margin consideration, and its impact on QoL due to tissue removal and dysfunction prompted the exploration of Mohs micrographic surgery (MMS) as a tissue-sparing alternative to wide local excision (WLE).  

Researchers conducted a retrospective study to systematically review surgical modalities used in managing anogenital SCC.  

They identified eligible articles through MEDLINE (via PubMed), Embase, Cochrane, and Scopus databases. Studies examining surgical management of anogenital SCC using WLE, including vulvectomy or MMS, were included.  

The results showed that 70 studies met inclusion criteria, with 46 analyzing WLE, 8 focusing on vulvectomy, and 24 examining MMS. The MMS had lower local recurrence rates, while regional and distant recurrence rates showed no difference. Recurrence rates for WLE were 17.7% (local), 5.1% (regional), and 6.0% (distant), compared to 5.0%, 3.8%, and 4.3% for MMS. Local recurrence was significantly higher with WLE (P < 0.0001), while regional (P = 0.444) and distant recurrence (P = 0.420) showed no significant difference. Study limitations included variations in tumor characteristics and follow-up durations, with the WLE group presenting with larger tumors.  

Investigators concluded that MMS demonstrated superior outcomes for local recurrence compared to WLE and vulvectomy, establishing it as a viable option for managing anogenital SCC. 

Source: onlinelibrary.wiley.com/doi/full/10.1111/ijd.17689