National utilization patterns of Mohs micrographic surgery for invasive melanoma and melanoma in situ

Abstract

Background: Although wide local excision continues to be commonly used for melanoma treatment, Mohs micrographic surgery (MMS) for the treatment of melanomas remains controversial.

Objective: We sought to determine national utilization patterns for MMS in the treatment of invasive melanoma and melanoma in situ.

Methods: A retrospective analysis of patients receiving surgical excision (MMS or wide local excision) for the treatment of invasive melanoma and melanoma in situ was performed using data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program.

Results: A total of 195,768 melanomas were diagnosed from 2003 through 2009 from the 17 SEER registries. Utilization of MMS for invasive melanoma and melanoma in situ increased by 60% from 2003 to 2008. Of all SEER-captured lesions treated by surgical excision in this time period, 3.5% (6872) were excised by MMS.

Limitations: Patient insurance status, physician reimbursement practices, and health care provider type were not addressed in this article.

Conclusion: Use of MMS for melanoma appears to be increasing. Future studies should explore whether this is associated with better outcomes.

Keywords: Mohs micrographic surgery; Surveillance, Epidemiology, and End Results; disparities; melanoma; population-based; surgical excision; utilization rates.