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Stanley J. Miller, Murad Alam, James S. Andersen, Daniel Berg, Christopher K. Bichakjian, Glen M. Bowen, Richard T. Cheney, L. Frank Glass, Roy C. Grekin, Alan L. Ho, Anne Kessinger, Nanette Liegeois, Daniel D. Lydiatt, Jeff Michalski, William H. Morrison, Kishwer S. Nehal, Kelly C. Nelson, Paul Nghiem, Thomas Olencki, Clifford S. Perlis, Ashok R. Shaha, Malika Tuli, Marshall M. Urist, Linda C. Wang, and John A. Zic

modified Mohs surgery 3 , 4 , 13 – 20 and traditional wide excision, 21 typically with 2- to 4-cm margins to investing fascia that are subsequently verified to be clear through traditional pathologic examination, are all methods to achieve complete

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Stanley J. Miller, Murad Alam, James Andersen, Daniel Berg, Christopher K. Bichakjian, Glen Bowen, Richard T. Cheney, L. Frank Glass, Roy C. Grekin, Anne Kessinger, Nancy Y. Lee, Nanette Liegeois, Daniel D. Lydiatt, Jeff Michalski, William H. Morrison, Kishwer S. Nehal, Kelly C. Nelson, Paul Nghiem, Thomas Olencki, Clifford S. Perlis, E. William Rosenberg, Ashok R. Shaha, Marshall M. Urist, Linda C. Wang, and John A. Zic

carcinomas that develop in the high-risk mask area of the face are more likely to recur and metastasize than those that develop on the trunk and extremities. Adapted with permission from Swanson NA. Mohs surgery: technique, indications, applications, and

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Stefanie L. Thorsness, Azael Freites-Martinez, Michael A. Marchetti, Cristian Navarrete-Dechent, Mario E. Lacouture, and Emily S. Tonorezos

Background: Radiotherapy (RT) is a risk factor for nonmelanoma skin cancer (NMSC), specifically basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but whether features, histology, or recurrence of NMSC after RT resemble those observed in the general population is unknown. Methods: A retrospective review (1994–2017) was performed within the Adult Long-Term Follow-Up Program and Dermatology Service at Memorial Sloan Kettering Cancer Center. Demographics, clinical features, histology, treatment, and recurrence were collected for this patient cohort that was under close medical surveillance. Pathology images were reviewed when available. Results: A total of 946 survivors (mean age, 40 years [SD, 13]) were assessed for NMSC. The mean age at first cancer diagnosis was 16 years (range, 0–40 years [11]), and the most common diagnosis was Hodgkin lymphoma (34%; n=318). In 63 survivors, 281 primary in-field lesions occurred, of which 273 (97%) were BCC and 8 (3%) were SCC. Mean intervals from time of RT to BCC and SCC diagnosis were 24 years (range, 2–44 years) and 32 years (range, 14–46 years), respectively. The most common clinical presentation of BCC was macule (47%; n=67), and the most common histologic subtypes were superficial for BCC (48%; n=131) and in situ for SCC (55%; n=5). Mohs surgery predominated therapeutically (42%; n=117), the mean duration of follow-up after treatment was 6 years (range, 12 days–23 years), and the 5-year recurrence rate was 1% (n=1). Conclusions: Most NMSCs arising in sites of prior RT were of low-risk subtypes. Recurrence was similar to that observed in the general population. Current guidelines recommend surgical intervention for tumors arising in sites of prior RT because they are considered to be at high risk for recurrence. These findings suggest that an expanded role for less aggressive therapy may be appropriate, but further research is needed.

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Luke William Martin, Miguel Cabalag, Anand Ramakrishnan, and Andrew Martin

appeared to be most efficacious, followed by radiotherapy. Chemoradiation/Chemotherapy appeared less efficacious. CONCLUSION : Surgical re-excision (especially Mohs surgery) with adequate margins remains the gold standard for close/positive margins in

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Nikki Tang and Desiree Ratner

Although it can occur anywhere on the body, BCC is most likely to arise on the head and neck, which has the greatest ultraviolet exposure. Treatment of appropriately selected BCCs with standard excision or Mohs surgery results in high cure rates. Non

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Grant A. McArthur

Basal Cell and Squamous Cell Skin Cancers Guidelines, version 1 , 2007 . Available at : http://www.nccn.org/professionals/physician_gls/default.asp . Accessed April 9, 2007 . 24. Garcia C Holman J Poletti E . Mohs surgery: commentaries

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Christopher K. Bichakjian, Thomas Olencki, Sumaira Z. Aasi, Murad Alam, James S. Andersen, Daniel Berg, Glen M. Bowen, Richard T. Cheney, Gregory A. Daniels, L. Frank Glass, Roy C. Grekin, Kenneth Grossman, Susan A. Higgins, Alan L. Ho, Karl D. Lewis, Daniel D. Lydiatt, Kishwer S. Nehal, Paul Nghiem, Elise A. Olsen, Chrysalyne D. Schmults, Aleksandar Sekulic, Ashok R. Shaha, Wade L. Thorstad, Malika Tuli, Marshall M. Urist, Timothy S. Wang, Sandra L. Wong, John A. Zic, Karin G. Hoffmann, and Anita Engh

American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and American Society for Mohs Surgery, developed an appropriate use criteria (AUC) document in the treatment of cutaneous neoplasms. 96 This was based on 270 clinical

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Christopher K. Bichakjian, Thomas Olencki, Murad Alam, James S. Andersen, Daniel Berg, Glen M. Bowen, Richard T. Cheney, Gregory A. Daniels, L. Frank Glass, Roy C. Grekin, Kenneth Grossman, Alan L. Ho, Karl D. Lewis, Daniel D. Lydiatt, William H. Morrison, Kishwer S. Nehal, Kelly C. Nelson, Paul Nghiem, Clifford S. Perlis, Ashok R. Shaha, Wade L. Thorstad, Malika Tuli, Marshall M. Urist, Timothy S. Wang, Andrew E. Werchniak, Sandra L. Wong, John A. Zic, Karin G. Hoffmann, Nicole R. McMillian, and Maria Ho

with 1- to 2-cm margins to the investing fascial layer remains the standard surgical technique. 36 Mohs surgery, modified Mohs surgery, or complete circumferential peripheral and deep-margin assessment (CCPDMA) may be considered if tissue sparing is

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Hans F. Schoellhammer, Gagandeep Singh, and Lucille Leong

) and a satellite lesion adjacent to the inferior vena cava (arrowhead). The patient previously had undergone Mohs surgeries for removal of unknown-type skin neoplasms from his nose; however, he had no other medical problems or previous

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Peter E. Clark, Philippe E. Spiess, Neeraj Agarwal, Matthew C. Biagioli, Mario A. Eisenberger, Richard E. Greenberg, Harry W. Herr, Brant A. Inman, Deborah A. Kuban, Timothy M. Kuzel, Subodh M. Lele, Jeff Michalski, Lance Pagliaro, Sumanta K. Pal, Anthony Patterson, Elizabeth R. Plimack, Kamal S. Pohar, Michael P. Porter, Jerome P. Richie, Wade J. Sexton, William U. Shipley, Eric J. Small, Donald L. Trump, Geoffrey Wile, Timothy G. Wilson, Mary Dwyer, and Maria Ho

patients with penile carcinoma in situ or noninvasive verrucous carcinoma, penile-preserving techniques may be used, including topical imiquimod (5%) or 5-FU cream; circumcision and wide local excision such as Mohs surgery; laser therapy (category 2B) using