Characteristics of non-melanoma skin cancers of the cutaneous perioral and vermilion lip treated by Mohs micrographic surgery.

The lip and surrounding perioral region are susceptible to non-melanoma skin cancer, but the distribution of basal cell and squamous cell carcinoma on the cutaneous and vermilion lips has not been fully elucidated. To investigate the distribution of cutaneous and vermilion lip non-melanoma skin cancer and to better describe risk factors, anatomic location, treatment characteristics and oncologic outcomes. A retrospective comparative case series of patients undergoing Mohs micrographic surgery (MMS) at a single academic centre for lip and perioral basal cell and squamous cell carcinoma was performed over a 5-year period. Demographics, medical comorbidities, surgical characteristics and recurrence status were extracted. Forty-five vermilion and 116 cutaneous lip cancers were identified. Basal cell carcinoma (BCC) was more common in the cutaneous perioral region, while squamous cell carcinoma (SCC) was more common on the vermilion lip (P < 0.001). BCCs were more common on the upper vermilion lip and SCCs were more common on the lower vermilion lip (P < 0.001). Within the cutaneous perioral region, both BCCs and SCCs were more common on the upper perioral surface (P = 0.002). Male gender was associated with lower lip SCC (P = 0.015). Smoking, immunosuppression, anticoagulant use and hydrochlorothiazide use were not associated with cancer type or location. Recurrences were rare, but more common in vermilion lip cancers (6.6%) compared to perioral cutaneous cancers (0.8%). Outcomes for all groups were similar; BCCs of the vermilion lip had significantly greater mean MMS stages (P < 0.001) as did SCCs (P = 0.05). Basal cell carcinoma is more commonly encountered on the cutaneous lip, whereas SCC is more common on the vermilion lip. Within the vermilion lip, BCC favours the upper lip, while SCC favours the lower lip. Within the cutaneous perioral region, both BCC and SCC favour the upper cutaneous tissue. Early stage lip cancers are curable by Mohs micrographic surgery with rare recurrences.

Queen D ，Knackstedt T ，Polacco MA ，Collins LK ，Lee K ，Samie FH ... -  《-》

Cutaneous lip tumours treated with Mohs micrographic surgery: clinical features and surgical outcome.

Leibovitch I ，Huilgol SC ，Selva D ，Paver R ，Richards S ... -  《BRITISH JOURNAL OF DERMATOLOGY》

Significant differences in nonmelanoma skin cancers of the upper and lower lip.

Squamous cell carcinomas (SCCs) generally have been reported to be more prevalent on the lips than basal cell carcinomas (BCCs), but in our experience, BCCs of the lips are common, particularly in women. To determine the tumor characteristics of lip SCCs and BCCs, including tumor type, anatomic location, and size; and to identify the relationship between patient characteristics, including age and sex, and lip tumor characteristics. Retrospective review of all BCCs and SCCs located on the lip treated between January 1995 and October 2010. Of 470 lip nonmelanoma skin cancers (NMSCs) identified, 71.4% were BCCs, and 28.6% were SCCs. Lower lip tumors were predominantly SCCs (79.8%, p < .01), whereas upper lip tumors were predominantly BCCs (85.7%, p < .01). Patients with lower lip tumors were significantly older (68.8 vs. 64.7, p = .02) and were largely male (70.8%, p < .01). Patients with SCCs were mostly male (62.2%, p = .02), whereas those with BCCs were predominantly female (68.8%, p < .01). Subgroup analysis showed that upper lip tumors were 98.1% cutaneous or more than 50% cutaneous, whereas 56.3% of lower lip tumors were mucosal or more than 50% mucosal; 87.1% of mucosal tumors were SCCs, whereas 83.6% of cutaneous tumors were BCCs (p < .01). Seventy-one percent of patients with mucosal tumors were men, whereas 67% of patients with cutaneous only tumors were women (p < .01). These data provide evidence of significant differences in patient and tumor characteristics between NMSCs of the upper and lower lips.

Dawn A ，Lawrence N 《-》

Recurrence of periocular basal cell carcinoma and squamous cell carcinoma after Mohs micrographic surgery: a retrospective cohort study.

Despite the widespread use of Mohs micrographic surgery (MMS) for periocular basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) - together called keratinocyte carcinoma (KC) - follow-up data regarding recurrences are limited. To investigate the recurrence rate for periocular KCs after MMS and to describe our experience with interdisciplinary collaborations. Patients with periocular KCs treated with MMS between 2006 and 2016 in a tertiary MMS referral hospital were included in this retrospective cohort study. Descriptive statistics were used to describe the MMS procedure-related characteristics. Using follow-up data from the electronic patient records and linkage with the Dutch nationwide network and registry of histopathology and cytopathology on 30 June 2017, the recurrence rate was evaluated and calculated using a cumulative incidence curve. In total, 683 (93·7%) periocular BCCs and 46 (6·3%) SCCs were treated with MMS. Three-quarters (n = 549) were primary tumours and the majority were located at the medial canthus or lower eyelid (n = 649, 89·0%). In 505 MMS procedures (69·3%) an oculoplastic surgeon participated, and in 63 patients (8·6%) a plastic surgeon performed the reconstruction. After a median follow-up of 46 months the recurrence rate was 3·0%, based on 22 recurrences (20 BCCs and two SCCs). MMS is an excellent treatment option for periocular KCs, with a low recurrence rate. Due to this specific anatomical location an interdisciplinary approach should pre-eminently be considered.

Weesie F ，Naus NC ，Vasilic D ，Hollestein LM ，van den Bos RR ，Wakkee M ... -  《-》

Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer -Basal Cell Carcinoma or Squamous Cell Carcinoma-Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study.

Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.

Miñano Medrano R ，López Estebaranz JL ，Sanmartin-Jiménez O ，Garcés JR ，Rodríguez-Prieto MA ，Vilarrasa-Rull E ，de Eusebio-Murillo E ，Escutia-Muñoz B ，Flórez-Menéndez Á ，Artola-Igarza JL ，Alfaro-Rubio A ，Redondo P ，Delgado-Jiménez Y ，Sánchez-Schmidt JM ，Allende-Markixana I ，Alonso-Pacheco ML ，García-Bracamonte B ，de la Cueva-Dobao P ，Navarro-Tejedor R ，Ciudad-Blanco C ，Carnero-González L ，Vázquez-Veiga H ，Cano-Martínez N ，Ruiz-Salas V ，Sánchez-Sambucety P ，Botella-Estrada R ，González-Sixto B ，Martorell-Calatayud A ，Gil P ，Morales-Gordillo V ，Toll-Abelló A ，Ocerin-Guerra I ，Mayor-Arenal M ，Suárez-Fernández R ，Sainz-Gaspar L ，Descalzo MA ，García-Doval I ，en nombre de REGESMOHS (Registro Español de Cirugía de Mohs) ... -  《-》