title: Comparison of outcomes for malignant melanoma of the face treated using Mohs micrographic surgery and wide local excision.
abstract: BACKGROUND
  Mohs micrographic surgery (MMS) is an accepted treatment for nonmelanoma skin cancer and has an evolving role in melanoma.
  
  
  OBJECTIVE
  To review oncologic outcomes of MMS and wide local excision (WLE) treatments for facial melanoma.
  
  
  METHODS
  A retrospective review of patients with invasive melanoma of the face between 1997 and 2007 identified from the Alberta Cancer Registry (Canada) was performed. Outcome measures were local recurrence (recurrence <2 cm from excision scar), distant recurrence (regional or systemic), and disease-specific survival.
  
  
  RESULTS
  One hundred fifty-one patients were available for analysis (60 MMS, 91 WLE). Median follow-up time was 48 months. The groups differed in tumor location and mitotic rate. Overall, there was no significant difference in 5-year local recurrence (7.9% WLE vs 6.2% MMS, p = .58), regional or systemic recurrence (18.8% vs 8.8%, p = 0.37) or disease-specific survival (82.8% vs 92.4%, p = .59). Breslow thickness was the only consistent predictor of local recurrence or other recurrence and disease-specific survival on multivariate analysis. Subset analysis of tumors with Breslow thickness less than 2 mm did not reveal any difference in outcomes.
  
  
  CONCLUSIONS
  Mohs micrographic surgery has oncologic outcomes of local recurrence, distant recurrence and overall survival similar to those of WLE for invasive facial melanoma.
authors.affiliation: Division of Surgical Oncology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Chin-Lenn
authors.forename: Tania
authors.initials: T
authors.lastname: Murynka
authors.forename: J Gregory
authors.initials: JG
authors.lastname: McKinnon
authors.forename: John P
authors.initials: JP
authors.lastname: Arlette
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005153:Facial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015580:Mohs Surgery; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000601:surgery; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome