Complications and Recurrences After Mohs Micrographic Surgery and Slow Mohs

Study Overview
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Brief Summary
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Mohs micro-graphic surgery (Mohs) is a tissue-sparing, surgical treatment for different types of skin cancer (e.g. basal cell carcinoma, squamous cell carcinoma, lentigo maligna (melanoma). It is a procedure performed with frozen sections. Slow Mohs, a variant of micro-graphic surgery, is performed by formalin fixation and paraffin-embedded sections. Both in Mohs and Slow Mohs tumor margins are assessed to achieve complete removal. This study aims to investigate the clinical presentation and outcomes (i.e. complications and recurrence rates) in patients treated with Mohs or Slow Mohs in the dermatology department of the Maastricht University Medical Center+ in Maastricht, the Netherlands.

Official Title
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Clinical Presentation and Surgical Outcomes in Patients With Skin Disorders Treated With Mohs Micrographic Surgery and Slow Mohs.

Conditions
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Skin Cancer, Complication, Complication of Surgical Procedure, Complication,Postoperative, Recurrence, Recurrent Disease, Cutaneous Squamous Cell Carcinoma, Basal Cell Carcinoma, Lentigo Maligna, Lentigo Maligna Melanoma

Intervention / Treatment
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* Procedure: Mohs surgery
* Procedure: Slow Mohs surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with a cutaneous lesion with an indication for Mohs micrographic surgery or Slow Mohs patients who received a treatment with either Mohs or Slow Mohs between 1 july 2017 and 1 july 2023 at the dermatology department of the Maastricht University Medical Center+. Exclusion Criteria: None.

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Mohs Micrographic Surgery<br>Patients treated with Mohs Micrographic Surgery in the dermatology department of Maastricht University Medical Center +, Maastricht, the Netherlands | Procedure: Mohs surgery<br>* Treatment of a skin disease by Mohs micrographic surgery technique (frozen sections).<br>* Other names: Mohs;|
| Slow Mohs<br>Patients treated with Slow Mohs in the dermatology department of Maastricht University Medical Center +, Maastricht, the Netherlands | Procedure: Slow Mohs surgery<br>* Treatment of a skin disease by Slow Mohs technique (formalin fixation and paraffin-embedded sections).<br>* Other names: Slow Mohs;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of complications | The incidence of complications after Mohs and Slow Mohs, expressed as absolute numbers and percentages. | Within 1 month after completion of the surgical intervention. | 
| Incidence of recurrence | The incidence of complications after Mohs and Slow Mohs, expressed as absolute numbers and percentages. Recurrence is defined as disease relapse after completion of treatment. | Up to 5 year after completion of the surgical intervention. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hazard ratio of predisposing factors for complications | Predisposing factors (patient- and tumor characteristics) for complications after Mohs and Slow Mohs, expressed in Hazard Ratio's and 95% confidence intervals. It is not possible to define the predisposing factors in advance, because this is currently unknown. We hypothesize the presence of diabetes, tobacco use and medication use to be predisposing factors for complications. | Within 1 month after completion of the surgical intervention. | 
| Hazard ratio of predisposing factors for recurrence | Predisposing factors (patient- and tumor characteristics) for recurrences after Mohs and Slow Mohs, expressed in Hazard Ratio's and 95% confidence intervals. It is not possible to define the predisposing factors in advance, because this is currently unknown. We hypothesize incomplete treatment, worse prognostic tumor factors (Stage III of IV, presence of perineural invasion or lymphovascular invasion) to be predisposing factors for recurrence. | Up to 5 year after completion of the surgical intervention. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Clinical presentation, Outcomes, Mohs micrographic surgery, Slow Mohs, Micrographic surgery