Institutional Adherence to Current Mohs Surgery Appropriate Use Criteria with Reasons for Nonadherence and Recommendations for Future Versions

Academic Article


  • BACKGROUNDThe appropriate use criteria (AUC) were established to optimize the use of Mohs micrographic surgery (MMS) and confer the highest possible clinical benefit to the patient.OBJECTIVEWe documented our adherence to AUC and review reasons for nonadherence regarding lesions classified as inappropriate, in the hopes of informing future versions of the AUC.MATERIALS AND METHODSA retrospective review of 1,000 consecutive patients who underwent MMS at a single institution. A total of 1,318 biopsy-proven nonmelanoma skin cancers were treated with MMS, and each skin cancer that underwent MMS was classified as appropriate, uncertain, or inappropriate based on the AUC.RESULTSData were collected on 1,318 lesions with 1,237 (93.9%) categorized as appropriate, 59 (4.5%) uncertain, and 22 (1.7%) not appropriate. The primary variables that determined appropriateness were type of cancer (p =.001), size (p <.001), and area of body (p <.001).CONCLUSIONInstitutional adherence to AUC was high, with 93.9% of treated tumors classified as appropriate, 4.5% as uncertain and 1.7% as inappropriate. By far the most commonly reported reason for performing MMS on an inappropriate lesion in our review was the treatment of adjacent lesions in 1 session.
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    Digital Object Identifier (doi)

    Author List

  • Stancut E; Melvin OG; Griffin RL; Phillips CB; Huang CC
  • Start Page

  • 290
  • End Page

  • 292
  • Volume

  • 48
  • Issue

  • 3