Sanchez-Schmidt, J.M. (Julia M.)

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    Risk factors and rate of recurrence after Mohs surgery in basal cell and squamous cell carcinomas: a nationwide prospective cohort (REGESMOHS, Spanish Registry of Mohs Surgery)
    (Society for the Publication of Acta Dermato-Venereologica, 2021) Cano-Martínez, N. (Natividad); Ruiz-Salas, V. (Verónica); Toll-Abelló, A. (Agustí); Sanchez-Schmidt, J.M. (Julia M.); Botella-Estrada, R. (Rafael); Vilarrasa-Rull, E. (Eva); Alfaro-Rubio, A. ( Alberto); Sánchez-Sambucety, P. (Pedro); Tomás-Velázquez, A. (Alejandra); Vázquez-Veiga, H. (Hugo); Artola-Igarza, J.L. (Juan L.); Descalzo, M.A. (Miguel A.); García-Bracamonte, B. (Beatriz); Miñano-Medrano, R. (Román); Delgado-Jiménez, Y. (Yolanda); Gil-Sanchez, M.P. (María Pilar); Mayor-Arenal, M. (Matías); Sanmartin-Jiménez, O. (Onofre); Sainz-Gaspar, L. (Laura); Cueva-Dobao, P. (Pablo) de la; García-Doval, I. (Ignacio); Gonzalez-Sixto, B.(Beatriz); Navarro-Tejedor, R. (Raquel); Flórez-Menéndez, A. (Ángeles); González, L. (Lucía); Eusebio-Murillo, E. (Esther) de; Ocerin-Guerra, I. (Izascun); Suárez-Fernández, R. (Ricardo); Rodríguez-Prieto, M.A. (Manuel A.); Ciudad-Blanco, C. (Cristina); Allende-Markixana, I. (Irati); Lopez-Estebaranz, J.L. (J. L.); Martorell-Calatayud, A. (Antonio); Redondo-Bellón, P. (Pedro); Garcés, J.R. (Joan R.); Escutia-Muñoz, B. (Begoña); Morales-Gordillo, V. (Victoriano); Alonso-Pacheco, L. (L.)
    Randomized studies to assess the efficacy of Mohs micrographic surgery in basal cell and squamous cell carcinomas are limited by methodological and ethical issues and a lack of long follow-up periods. This study presents the "real-life" results of a nationwide 7-years cohort on basal cell carcinoma and squamous cell carcinoma treated with Mohs micrographic surgery. A prospective cohort was conducted in 22 Spanish centres (from July 2013 to February 2020) and a multivariate analysis, including characteristics of patients, tumours, surgeries and follow-up, was performed. A total of 4,402 patients followed up for 12,111 patient-years for basal cell carcinoma, and 371 patients with 915 patient-years of follow-up for squamous cell carcinoma were recruited. Risk factors for recurrence included age, non-primary tumours and more stages or unfinished surgeries for both tumours, and immunosuppression for squamous cell carcinoma. Incidence rates of recurrence were 1.3 per 100 person-years for basal cell carcinoma (95% confidence interval 1.1-1.5) and 4.5 for squamous cell carcinoma (95% confidence interval 3.3-6.1), being constant over time (0-5 years). In conclusion, follow-up strategies should be equally intense for at least the first 5 years, with special attention paid to squamous cell carcinoma (especially in immunosuppressed patients), elderly patients, non-primary tumours, and those procedures requiring more stages, or unfinished surgeries.