Operative expectations for Mohs surgery in patients with chronic lymphocytic leukemia: A multicenter retrospective cohort study.
| Autor: | Hamel RK; DermSurgery Associates, Houston, Texas., Phillipps J; Washington University School of Medicine, St. Louis, Missouri., Nisar T; Houston Methodist Hospital, Houston, Texas., Hall E; DermSurgery Associates, Houston, Texas., Council L; Division of Dermatology, Washington University, St. Louis, Missouri., Kimyai-Asadi A; DermSurgery Associates, Houston, Texas., Goldberg LH; DermSurgery Associates, Houston, Texas. |
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| Jazyk: | angličtina |
| Zdroj: | JAAD international [JAAD Int] 2023 Mar 13; Vol. 11, pp. 193-199. Date of Electronic Publication: 2023 Mar 13 (Print Publication: 2023). |
| DOI: | 10.1016/j.jdin.2023.02.014 |
| Abstrakt: | Background: Patients with chronic lymphocytic leukemia (CLL) are immunocompromised and have both a higher incidence of and more aggressive skin cancers, often requiring treatment with Mohs micrographic surgery. Objective: Characterize operative expectations for Mohs surgery in patients with CLL. Methods: Multicenter retrospective cohort study. Results: One hundred fifty-nine tumors from 99 patients with CLL were matched 1:4 with controls. Cases had higher odds for requiring at least 3 stages during Mohs surgery compared to controls (odds ratio = 1.91; 95% CI [1.21-3.02]; P = .01). The mean number of Mohs stages in cases was 1.97 (±0.92) compared with 1.67 (±0.87) in controls ( P = .0001). A regression analysis showed that cases had larger postoperative tumor areas (cm 2 ) versus controls (mean = 5.57 vs 4.47; estimate difference Δβ = 1.10 cm 2 ; 95% CI [0.18-2.03]; P = .02). In logistic regression, cases were twice as likely to receive a flap repair compared to controls (odds ratio = 2.45; 95% CI [1.58-3.8]). Limitations: Retrospective cohort study and lack of histologic subtyping of tumors. Conclusion: Patients with CLL require more Mohs stages to attain clear surgical margins, have larger postoperative defect areas, and require more advanced repair techniques compared to a control population without CLL. These findings are essential for preoperative planning and patient counseling and further support the use of Mohs surgery in patients with CLL. Competing Interests: None disclosed. (© 2023 by the American Academy of Dermatology, Inc. Published by Elsevier Inc.) |
| Databáze: | MEDLINE |
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