title: National utilization patterns of Mohs micrographic surgery for invasive melanoma and melanoma in situ.
abstract: BACKGROUND
  Although wide local excision continues to be commonly used for melanoma treatment, Mohs micrographic surgery (MMS) for the treatment of melanomas remains controversial.
  
  
  OBJECTIVE
  We sought to determine national utilization patterns for MMS in the treatment of invasive melanoma and melanoma in situ.
  
  
  METHODS
  A retrospective analysis of patients receiving surgical excision (MMS or wide local excision) for the treatment of invasive melanoma and melanoma in situ was performed using data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program.
  
  
  RESULTS
  A total of 195,768 melanomas were diagnosed from 2003 through 2009 from the 17 SEER registries. Utilization of MMS for invasive melanoma and melanoma in situ increased by 60% from 2003 to 2008. Of all SEER-captured lesions treated by surgical excision in this time period, 3.5% (6872) were excised by MMS.
  
  
  CONCLUSIONS
  Patient insurance status, physician reimbursement practices, and health care provider type were not addressed in this article.
  
  
  CONCLUSIONS
  Use of MMS for melanoma appears to be increasing. Future studies should explore whether this is associated with better outcomes.
authors.affiliation: Albert E. Einstein College of Medicine, Bronx, New York. Electronic address: katevviola@gmail.com.
authors.forename: Kate V
authors.initials: KV
authors.lastname: Viola
authors.affiliation: Rutgers University-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Kameron S
authors.initials: KS
authors.lastname: Rezzadeh
authors.affiliation: Connecticut Tumor Registry, State of Connecticut Department of Public Health, Hartford, Connecticut.
authors.forename: Lou
authors.initials: L
authors.lastname: Gonsalves
authors.affiliation: Albert E. Einstein College of Medicine, Bronx, New York.
authors.forename: Payal
authors.initials: P
authors.lastname: Patel
authors.affiliation: Cancer Outcomes Policy and Effectiveness Research Center, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Cary P
authors.initials: CP
authors.lastname: Gross
authors.affiliation: Albert E. Einstein College of Medicine, Bronx, New York.
authors.forename: Jane
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Albert E. Einstein College of Medicine, Bronx, New York.
authors.forename: Emily
authors.initials: E
authors.lastname: Stamell
authors.affiliation: Albert E. Einstein College of Medicine, Bronx, New York.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Turner
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods / Q000706:statistics & numerical data*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D016017:Odds Ratio; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome; D000096142:Cutaneous Malignant Melanoma
keywords: Mohs micrographic surgery; Surveillance, Epidemiology, and End Results; disparities; melanoma; population-based; surgical excision; utilization rates