Clinicohistopathologic profile of patients who underwent Mohs micrographic surgery at the Dermatology Center of St. Luke's Medical Center from 2003-2008

ABSTRACT

BACKGROUND: Mohs Micrographic Surgery (MMS) is the microscopically-controlled excision of skin cancer. Although there have been several international studies on MMS for nonmelanoma skin cancer (NMSC) including 1 from Korea, there have been no reports yet on MMS in the Philippines. This is the first study on MMS for NMSC in the Philippines.OBJECTIVE: To describe the clinical and histopathologic profile of all patients who underwent MMS at the Dermatology Center, St. Luke's Medical Center, from March 2003- March 2008.METHODS: A retrospective study was conducted on all MMS cases done at the Mohs Surgery Unit of the Dermatology Center in St. Luke's Medical Center from March 2003- March 2008. Demographic and clinicohistologic profile of all cases were reviewed. Three to five-year recurrence rate was reported.RESULTS: A total of 75 cases were reviewed and included in the study. The mean age of the study population was 61.29 years old and 90 percent belong to the >40 age group. The malefemale ratio was 31. There were almost equal number of Filipino and Caucasian patients. Most patients permanently reside in the Philippines, with a small percentage coming from nearby countries like Guam. One-fifth of the study population were retired military men. The most common tumor was basal cell carcinoma (BCC), primary cases outnumbering recurrent ones. The nose was the most common area affected with BCC, while the cheek was the most common site of squamous cell carcinoma (SCC). Majority of tumors done were d" 2 cm. The most common post-operative defect size incurred was also d" 2 cm. The most common primary indication for doing MMS was the location of the tumor. Most NMSCs were cleared after 2-3 stages. Local flaps were the most commonly used type of repair, followed by primary closure. Based on 3- to 5-year surveillance of cases done from 2003-2005, there has been no recurrence yet as of March 2008.CONCLUSION: The clinicohistopathologic profile of patients who underwent MMS in the Dermatology Center of St. Luke's Medical Center has similarities and differences with existing local and international literature. MMS, as offered by the first Mohs Surgery Unit in the country, caters mostly to the older age group with a predominance of the male population. The number of Filipino and Caucasian patients who underwent the procedure was almost equal. BCC is still the most common tumor treated in the Center with the face as the most common location. Most tumors were immediately cleared after few MMS stages. Success rate of the procedure in the Unit is very high, based on 3 to 5- year surveillance for recurrence.