TY - JOUR
T1 - How dermatologic surgeons decide to proceed with surgery for nonmelanoma skin cancer when site identification is initially uncertain
T2 - A nationwide, multicenter, prospective study
AU - Ahmed, Areeba
AU - Maisel-Campbell, Amanda
AU - Shi, Victoria J.
AU - Koza, Eric
AU - Ma, Melissa
AU - Haq, Misha
AU - Nadir, Umer
AU - Yi, Michael D.
AU - Dave, Loma
AU - Hisham, Farhana Ikmal
AU - Lin, Katherine A.
AU - Ibrahim, Sarah A.
AU - Kang, Bianca Y.
AU - Dirr, McKenzie A.
AU - Aylward, Juliet L.
AU - Bari, Omar
AU - Bhatti, Hamza
AU - Bolotin, Diana
AU - Cherpelis, Basil S.
AU - Cohen, Joel L.
AU - Condon, Sean
AU - Farhang, Sheila
AU - Firoz, Bahar
AU - Garrett, Algin B.
AU - Geronemus, Roy G.
AU - Golda, Nicholas J.
AU - Helming, Dyann
AU - Humphreys, Tatyana R.
AU - Hurst, Eva A.
AU - Jacobson, Oren H.
AU - Jiang, S. Brian
AU - Karia, Pritesh S.
AU - Kimyai-Asadi, Arash
AU - Kouba, David J.
AU - Council, M. Laurin
AU - Le, Marilyn
AU - MacFarlane, Deborah F.
AU - Maher, Ian A.
AU - Miller, Stanley J.
AU - Moioli, Eduardo K.
AU - Morrow, Meghan
AU - Neckman, Julia
AU - Pearson, Timothy
AU - Peterson, Samuel R.
AU - Poblete-Lopez, Christine
AU - Prather, Chad L.
AU - Ranario, Jennifer S.
AU - Rubin, Ashley G.
AU - Schmults, Chrysalyne D.
AU - Swanson, Andrew M.
AU - Urban, Christopher
AU - Xu, Y. Gloria
AU - Pearlman, Ross
AU - Yoo, Simon
AU - Harikumar, Vishnu
AU - Weil, Alexandra
AU - Schaeffer, Matthew
AU - Iyengar, Sanjana
AU - Poon, Emily
AU - Cahn, Brian A.
AU - Alam, Murad
N1 - Publisher Copyright:
© 2024
PY - 2025/1
Y1 - 2025/1
N2 - Background: Few studies show how dermatologic surgeons manage problems with site identification. Objective: To estimate frequency and characterize management of skin cancer treated by surgery when the anatomic location of the tumor is in question. Methods: Nationwide, prospective, multisite cohort study. Results: Among 17,076 cases at 22 centers, 98 (0.60%) were lesions in question for which site identification was initially uncertain, with these more often in patients who were male, older, and biopsied more than 30 days ago. Surgeons employed on average 5.0 (95% CI: 4.61-5.39) additional techniques to confirm the site location, with common approaches including: re-checking available documentation (90 lesions, 92%); performing an expanded physical examination (89 lesions, 91%); and asking the patient to point using a mirror (61 lesions, 62%). In 15%, photographs were requested from the biopsying provider, and also in 15%, frozen section biopsies were obtained. In 10%, the referring physician was contacted. Eventually, surgeons succeeded in definitively identifying 82% (80 of 98) of initially uncertain sites, with the remaining 18% (18 of 98) postponed. Most postponed surgeries were at non-facial sites. Limitations: Sites were academic centers. Conclusions: When the anatomic location of the tumor is uncertain, dermatologic surgeons use multiple methods to identify the site, and sometimes cases are postponed.
AB - Background: Few studies show how dermatologic surgeons manage problems with site identification. Objective: To estimate frequency and characterize management of skin cancer treated by surgery when the anatomic location of the tumor is in question. Methods: Nationwide, prospective, multisite cohort study. Results: Among 17,076 cases at 22 centers, 98 (0.60%) were lesions in question for which site identification was initially uncertain, with these more often in patients who were male, older, and biopsied more than 30 days ago. Surgeons employed on average 5.0 (95% CI: 4.61-5.39) additional techniques to confirm the site location, with common approaches including: re-checking available documentation (90 lesions, 92%); performing an expanded physical examination (89 lesions, 91%); and asking the patient to point using a mirror (61 lesions, 62%). In 15%, photographs were requested from the biopsying provider, and also in 15%, frozen section biopsies were obtained. In 10%, the referring physician was contacted. Eventually, surgeons succeeded in definitively identifying 82% (80 of 98) of initially uncertain sites, with the remaining 18% (18 of 98) postponed. Most postponed surgeries were at non-facial sites. Limitations: Sites were academic centers. Conclusions: When the anatomic location of the tumor is uncertain, dermatologic surgeons use multiple methods to identify the site, and sometimes cases are postponed.
KW - Mohs micrographic surgery
KW - cutaneous surgery
KW - dermbase
KW - lesion in question
KW - skin cancer
KW - uncertain lesion location
UR - http://www.scopus.com/inward/record.url?scp=85206986158&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2024.08.073
DO - 10.1016/j.jaad.2024.08.073
M3 - Article
C2 - 39307352
AN - SCOPUS:85206986158
SN - 0190-9622
VL - 92
SP - 85
EP - 91
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 1
ER -