The following is a summary of “Limitations in the literature regarding Mohs surgery and staged excision for melanoma: A critical review of quality and data reporting,” published in the FEBRUARY 2023 issue of Dermatology by Adalsteinsson, et al.

Numerous studies have been conducted on Mohs micrographic surgery and staged excision as potential treatments for primary cutaneous melanoma, but there needs to be more examination of these studies for possible biases.

Researchers evaluated articles on Mohs micrographic surgery and staged excision for melanoma using the “Risk of Bias in Non-randomized Studies of Interventions” (ROBINS-I) criteria, which measures bias in seven categories.

Of the 48 studies examined, 47 (97.9%) showed serious or critical bias. None of the studies were randomized controlled trials. Poorly defined outcomes were identified as the most frequent cause of critical bias, while changes in the intervention were the least frequently observed form of bias.

The current body of literature on Mohs micrographic surgery and staged excision has several limitations due to serious or critical bias in one or more ROBINS-I criteria. Local recurrence rate definitions were often poorly needed to be better or undefined entirely. Longer follow-up periods, precise tumor classifications, and prospective, randomized study designs were necessary to improve the quality of future research.

Reference: jaad.org/article/S0190-9622(21)00772-6/fulltext