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Review
. 2025 Jun;15(6):1283-1306.
doi: 10.1007/s13555-025-01410-5. Epub 2025 Apr 20.

Mohs Micrographic Surgery and Improved Survival in Skin Cancer: A Narrative Review

Pablo Balado-Simó #  1 , Miguel Mansilla-Polo #  2   3 , Daniel Morgado-Carrasco  4   5
Affiliations
Review

Mohs Micrographic Surgery and Improved Survival in Skin Cancer: A Narrative Review

Pablo Balado-Simó et al. Dermatol Ther (Heidelb). 2025 Jun.

Abstract

Mohs micrographic surgery (MMS) has been shown to achieve very low recurrence rates in skin cancer, and some studies suggest it may improve survival. We conducted a narrative review to assess the impact of MMS on the survival of patients with various skin cancer subtypes. Some retrospective studies suggest that MMS may enhance survival in patients with head and neck melanoma, lentigo maligna, lentigo maligna melanoma, invasive cutaneous squamous cell carcinoma (cSCC) (especially high-risk cSCC), and high-risk dermatofibrosarcoma protuberans, and, possibly, with certain malignant adnexal tumors as well. It is crucial to take these findings into account so as to appropriately prioritize patients and ensure accessibility of MMS. In both Merkel cell carcinoma and leiomyosarcoma, MMS has not consistently demonstrated improved survival compared with wide excision. Evidence regarding improved survival in extramammary Paget's disease remains limited.

Keywords: Cutaneous squamous cell carcinoma; Lentigo maligna melanoma; Melanoma; Merkel cell carcinoma; Mohs surgery; Survival.

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Conflict of interest statement

Declarations. Conflict of Interest: The three authors (Pablo Balado-Simó, Miguel Mansilla-Polo, and Daniel Morgado-Carrasco) have nothing to disclose. Ethical Approval: This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors. The procedures followed here were in accordance with the ethical standards of the committee responsible for human experimentation and with the 1975 Helsinki Declaration, revised in 1983. We have not used patients’ names, initials, or hospital numbers.

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