Retrospective cohort study shows improved surgical outcomes for advanced skin cancer with coordinated Mohs and OR resection, indicating effective treatment strategies.
Background Locally advanced and metastatic nonmelanoma skin cancers are frequently managed with operating room (OR)‐based resection, lacking real‐time margin assessment. Mohs micrographic surgery provides immediate margin evaluation but is limited in deeply invasive or metastatic disease. A coordinated approach combines the strengths of both strategies. Methods Retrospective cohort study of patients with locally advanced tumors, with or without regional metastases, treated with Mohs surgery followed by OR resection. Results Twenty‐one patients had median follow‐up of 30 (IQR, 14–87) weeks. Mohs cleared the peripheral margin in all cases and the deep margin in 11 (52%) cases. Ten (48%) cases required OR resection of the deep margin, and 10 (48%) required resection of metastatic disease. Median time between surgeries was 2 (IQR, 1–16) days. Three patients (14%) developed recurrence. No disease‐specific deaths occurred. Conclusion Coordinating Mohs surgery with OR resection enables full margin assessment, surgical clearance of extensive disease, and immediate reconstruction.
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Mortelliti et al. (2026) studied this question.
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