Cirurgia micrográfica de Mohs: estudo de 93 tumores operados em um centro de referência no Rio de Janeiro / Mohs micrographic surgery: a study of 93 tumors operated on in a specialist center in Rio de Janeiro

RESUMO

Introdução: A cirurgia micrográfica de Mohs é opção terapêutica que aumenta a taxa de cura de vários tipos de câncer de pele, com maior preservação tecidual e menores taxas de recidiva. Objetivo: Traçar o perfil clínico e histológico dos tumores operados pela cirurgia micrográfica de Mohs, em serviço privado de referência nessa técnica no município do Rio de Janeiro, Brasil, e relacioná-lo com o número de fases e tipo de reconstrução cirúrgica realizada. Métodos: Estudo retrospectivo, observacional, transversal, com revisão de prontuários. Resultados: Foram relacionados 93 tumores em 84 pacientes operados no período entre abril/2010 e agosto/2012 e seguidos até agosto/2013 (12 a 42 meses). Dados encontrados 47,61% homens e 52,38% mulheres; idade média de 62,89 anos; fototipos predominantes II (44%) e III (43%); seis casos (6,45%) de carcinoma espinocelular; 87 (93,54%) de carcinoma basocelular; 74,19% de tumores primários; nariz como localização mais frequente (46,24%); uma fase cirúrgica realizada na maioria dos casos, tendo sido o retalho (44%) o tipo de fechamento mais realizado. Houve recidiva em um paciente, que foi reoperado em outubro/2012 e segue sem recidiva. Conclusões: A cirurgia de Mohs mostrou-se eficaz, com altos índices de cura e mínima taxa de recidiva, especialmente nas lesões da área de risco do H da face.

ABSTRACT

ORIGINAL ARTICLE Mohs micrographic surgery a study of 93 tumors operated on in a specialist center in Rio de Janeiro Cirurgia micrográfica de Mohs estudo de 93 tumores operados em um centro de referência no Rio de Janeiro Frederico H. Sanchez1; Juliany Lima Estefan2; Lidiany Lima Estefan3 1. Head of the Center for Micrographic Surgery of Rio de Janeiro, Policlínica Ronaldo Gazolla-Rio de Janeiro (RJ); Preceptor at the Dermatologic Surgery Fellow Program, Hospital Federal Bonsucesso-Rio de Janeiro (RJ), Brazil 2. Dermatologist Physician, MSc in Clinical Medicine from the Universidade Federal do Rio de Janeiro (UFRJ)-Rio de Janeiro (RJ), Brazil 3. Collaborating Physician at the Center for Micrographic Surgery of Rio de Janeiro, Policlínica Ronaldo Gazolla Received on 10 August 2013 Approved on 9 October 2013 Financial support None Conflict of interest None The present study was carried out at the Center for Micrographic Surgery of Rio de Janeiro-Rio de Janeiro (RJ), Brazil. Correspondence Centro de Cirurgia Micrográfica do Rio de Janeiro Dr. Frederico H. Sanchez Rua da Assembléia 10 / sala 2807-Centro Cep 20011-000-Rio de Janeiro-RJ, Brazil E-mail fredhsanchez@gmail.com Abstract Introduction: Mohs micrographic surgery is a treatment option that increases the cure rate in various types of skin cancer, offering greater tissue preservation and lower recurrence rates. Objective: To describe clinically and histologically the tumors operated on with Mohs micrographic surgery, and to draw correlations to the number of stages and the type of surgical reconstruction performed. The operations were performed at a private clinic in the municipality of Rio de Janeiro, Brazil that is a specialist center for this technique. Methods: Retrospective, observational, cross-sectional/transversal study was carried out based on the review of medical records. Results: A study was conducted of 93 tumors in 84 patients, operated on between April 2010 and August 2012, and followed up with until August 2013 (12 to 42 months). Findings: 47.61% of patients were men and 52.38% were women, the mean age was 62.89 years; predominant phototypes II (44%) and III (43%); 6 cases (6.45%) of squamous cell carcinoma, 87 (93.54%) of basal cell carcinoma; 74.19% were primary tumors; the nose was the most frequent site (46.24%); a single surgical stage was performed in most cases, with flaps (44%) being the more frequently performed type of closure. There was recurrence in one patient, who required reoperation in October 2012 and followed without new recurrence. Conclusions: Mohs surgery has proven effective with high cure rates and a minimal recurrence rate, especially in lesions located in the face's H area of risk.