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Abstract：
How patient and tumor factors influence clearance margins and the number of Mohs Micrographic Surgery (MMS) stages when treating basal cell carcinoma (BCC) remains widely uncharacterized. It is important to elucidate these relationships, as surgical outcomes may be compared nationally between colleagues. Our objective is to evaluate the relationships between defect size and patient demographics, as well as between BCC subtypes and the number of MMS stages. Our second objective is to compare practice patterns and characteristics of patients requiring MMS at academic centers and private practices. A retrospective chart review was performed using data collected at academic centers (2015-2018) and private practices (2011-2018) of BCC patients older than 18 years old who underwent MMS. In total, 7651 patients with BCC requiring MMS were identified. Academic center adjusted analyses demonstrated clearance margins 0.1 mm higher for every year\'s increase in age (p < 0.0001) and 0.25 increase in MMS stages for high-risk BCC (p < 0.0001). Private practice adjusted analyses demonstrated clearance margins 0.04 mm higher for every year\'s increase in age (p < 0.0001). Clearance margins correlate with older age, and additional MMS stages correlate with high-risk BCC, suggesting the role patient and tumor factors may play in predicting tumor clearance and MMS stages.
摘要：
在治疗基底细胞癌（BCC）时，患者和肿瘤因素如何影响清除边缘和Mohs显微外科手术（MMS）分期的数量仍未得到广泛表征。阐明这些关系很重要，因为手术结果可以在全国范围内与同事进行比较。我们的目标是评估缺陷大小与患者人口统计学之间的关系，以及BCC亚型和MMS级数之间。我们的第二个目标是比较在学术中心和私人诊所需要MMS的患者的实践模式和特征。使用在学术中心（2015-2018）和私人诊所（2011-2018）收集的18岁以上接受MMS的BCC患者的数据进行回顾性图表审查。总的来说,确定了7651例需要MMS的BCC患者。学术中心调整后的分析显示，年龄每年增加0.1mm（p<0.0001），高危BCC的MMS分期增加0.25（p<0.0001）。经过私人实践调整的分析显示，随着年龄的增长，间隙间隙提高了0.04mm（p<0.0001）。间隙边缘与年龄相关，额外的彩信阶段与高风险的BCC相关，提示患者和肿瘤因素可能在预测肿瘤清除和MMS分期中发挥作用。
