title: Five-year outcomes of wide excision and Mohs micrographic surgery for primary lentigo maligna in an academic practice cohort.
abstract: BACKGROUND
  Wide local excision with 5-mm margins is the standard of care for lentigo maligna (LM). Mohs micrographic surgery (MMS) is used increasingly to treat this tumor.
  
  
  OBJECTIVE
  To study the authors' experience with these 2 approaches.
  
  
  METHODS
  Primary LM cases treated at the authors' institution from January 1, 1995, through December 31, 2005, were studied retrospectively. Main outcome measures were recurrence and outcomes after treatment for recurrence.
  
  
  RESULTS
  In total, 423 LM lesions were treated in 407 patients: 269 (64%) with wide excision and 154 (36%) with MMS. In the MMS group (primarily larger head and neck lesions with indistinct clinical margins), recurrence rates were 3 of 154 (1.9%). In the wide excision group (primarily smaller, nonhead and neck, or more distinct lesions), recurrence rates were 16 of 269 (5.9%). Each of the 16 recurrences was biopsy proven and treated surgically: 6 by standard excision and 10 by MMS.
  
  
  CONCLUSIONS
  This follow-up study of LM surgical treatments shows excellent outcomes for wide excision and MMS. Because this is a nonrandomized retrospective study, no direct comparisons between the 2 treatments can be made. When recurrences occurred, repeat surgery, either standard excision or MMS, was usually sufficient to provide definitive cure.
authors.affiliation: *Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, Minnesota; †Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota; ‡Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. Dr. Frohm is now with the Department of Dermatology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Hou
authors.forename: Kurtis B
authors.initials: KB
authors.lastname: Reed
authors.forename: Richelle M
authors.initials: RM
authors.lastname: Knudson
authors.forename: Sultan A
authors.initials: SA
authors.lastname: Mirzoyev
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.forename: Marcus L
authors.initials: ML
authors.lastname: Frohm
authors.forename: Jerry D
authors.initials: JD
authors.lastname: Brewer
authors.forename: Clark C
authors.initials: CC
authors.lastname: Otley
authors.forename: Randall K
authors.initials: RK
authors.lastname: Roenigk
mesh_terms: D062109:Dermatologic Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000601:surgery*; D008297:Male; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome