Examining These Patient Variables May Help Predict Aggressive Basal Cell Carcinomas

Size, aggressive pathology, recurrence, and site on the body all were linked with an increased number of Mohs micrographic surgery (MMS) stages for patients with basal cell carcinomas (BCC), in a study that was presented this week at the American College of Mohs Surgery (ACMS) 54th annual meeting in Philadelphia, Pennsylvania.

Amit Om, MD, who is the dermatology resident physician at Bennett Surgery Center, presented their group’s data, which was a retrospective analysis of 11 patients and tumor variables and the mean MMS stage number for 1000 consecutive BCCs. The 11 patient variables, according to the abstract, were “gender, internal/external referral, immune status, aggressive pathology, head/neck vs trunk/extremities, AUC location (H, M, L), duration, pre-operative AUC score, and largest pre-operative length.”

The researchers noted that on bivariate analysis some of the variables that were predictive of an increased number of MMS stages for patients with BCCs included: “[BCC] had been treated previously (2.4 vs 1.93, P < .0001), location on the head/neck (2.07 vs 1.61, P = .0001), location in “H” area as defined by the appropriate use criteria (AUC) (2.17 vs 1.88 vs 1.49, P = .0000), pre-operative AUC size “4,” (2.45 vs 2.14 vs 1.98 vs 1.77, P = .0000), pre-operative AUC score 7-9 vs 4-6 and 1-3 (2.04 vs 1.46 vs 1.3, P = .0000), largest pre-operative length greater than 1.0 cm (2.21 vs 1.88, P = .0001), aggressive pathology (2.16 vs 1.95, P = .0138) and duration greater than or equal to 16 months (2.17 vs 1.97, P = .031.)”

Size, aggressive pathology, recurrence and body site were all statistically significant in multivariate analysis, which allowed their team to create a predictive model of who would go on to develop aggressive BCCs, which can be a powerful tool in deciding treatment approaches, Om said.

“How will this impact your practice?” Om said. “For anyone doing complex tumors, this type of data can protect you…you can use this Mohs data to triage your data.”

Reference:

Om A. Predictive factors that increase the number of Mohs micrographic surgery stages for basal cell carcinomas. Presented at: American College of Mohs Surgery. May 12-15, 2022. Philadelphia, PA.