Mohs vs. Surgical Excision for High-Risk BCCs

Mohs surgery is usually recommended for recurrent basal cell carcinomas (BCCs) and for primary BCCs involving the central face and periauricular areas or with aggressive pathology. However, there have been few if any prospective trials to support this recommendation. Investigators of a continuing, prospective, randomized, controlled trial comparing Mohs with excision now report 5-year results (for 2-year results, see JW Dermatol Dec 14 2004). In this trial, recurrent facial BCCs, primary BCCs 1 cm in diameter or larger located in the “H-zone” of the face, and those with an aggressive pathology were randomized to conventional excision with 3-mm margins or to Mohs surgery with 3-mm margins at each layer. Excisional specimens were examined as …