TY - JOUR
T1 - Factors Influencing General Dermatologists When Referring Patients With Head and Neck Melanoma for Mohs Micrographic Surgery
T2 - A Nationwide Cross-Sectional Survey
AU - Neill, Brett C.
AU - Siscos, Spyros M.
AU - Bar, Anna A.
AU - Seger, Edward W.
AU - Latour, Emile
AU - Tolkachjov, Stanislav N.
N1 - Publisher Copyright:
© 2023 by the American Society for Dermatologic Surgery, Inc.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: Mohs micrographic surgery (MMS) for cutaneous melanoma has demonstrated higher cure rates, lower local recurrence rates, and improved survival compared with wide local excision (WLE). However, factors affecting referrals by general dermatologists for MMS of head and neck melanoma (HNM) are unknown. Objective: To elucidate referral factors and treatment perspectives of general dermatologists regarding MMS for melanoma in situ (MIS)/lentigo maligna (LM) and early-stage melanoma on the head and neck. Materials and Methods: A cross-sectional analysis was performed using survey responses of general dermatologists with membership in the American Academy of Dermatology. Results: A total of 231 and 132 of the 402 responding general dermatologists routinely referred melanoma in situ MIS/LM and early invasive melanoma for MMS, respectively. Lack of local access to a Mohs surgeon was the most common deterring reason for MIS/LM referral to MMS, whereas the preference for WLE was the most common deterring reason for early invasive melanoma. Conclusion: Lack of local access to a Mohs surgeon treating HNM with MMS is the primary barrier in referrals to Mohs surgeons for MIS and LM. Among general dermatologists, WLE is preferred for early invasive HNM.
AB - Background: Mohs micrographic surgery (MMS) for cutaneous melanoma has demonstrated higher cure rates, lower local recurrence rates, and improved survival compared with wide local excision (WLE). However, factors affecting referrals by general dermatologists for MMS of head and neck melanoma (HNM) are unknown. Objective: To elucidate referral factors and treatment perspectives of general dermatologists regarding MMS for melanoma in situ (MIS)/lentigo maligna (LM) and early-stage melanoma on the head and neck. Materials and Methods: A cross-sectional analysis was performed using survey responses of general dermatologists with membership in the American Academy of Dermatology. Results: A total of 231 and 132 of the 402 responding general dermatologists routinely referred melanoma in situ MIS/LM and early invasive melanoma for MMS, respectively. Lack of local access to a Mohs surgeon was the most common deterring reason for MIS/LM referral to MMS, whereas the preference for WLE was the most common deterring reason for early invasive melanoma. Conclusion: Lack of local access to a Mohs surgeon treating HNM with MMS is the primary barrier in referrals to Mohs surgeons for MIS and LM. Among general dermatologists, WLE is preferred for early invasive HNM.
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U2 - 10.1097/DSS.0000000000003754
DO - 10.1097/DSS.0000000000003754
M3 - Article
C2 - 36989088
AN - SCOPUS:85158914317
SN - 1076-0512
VL - 49
SP - 451
EP - 455
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 5
ER -