Mohs Surgery for Melanoma: Current Evidence and Guidelines

In this presentation, Wesley Yu from Oregon Health and Science University discusses Mohs surgery for melanoma, covering current evidence and guidelines. The talk begins by comparing Mohs surgery with traditional excision techniques, highlighting a notable difference in local recurrence rates found in a 2021 meta-analysis, showing Mohs surgery achieved a significantly lower rate. However, Yu stresses the complexity of interpreting these outcomes due to potential selection bias in retrospective studies. He raises questions about the quality of life and cosmetic outcomes associated with Mohs surgery, acknowledging both its potential to offer good results but also cautioning against excessive tissue removal. Regarding survival rates, Yu notes mixed findings from recent studies, with no definitive advantage of Mohs surgery over wide excision. He emphasizes that current guidelines generally prefer wide excision with permanent sectioning for melanoma unless specific circumstances warrant Mohs surgery. Yu concludes by stating that while Mohs surgery can be valuable in certain cases, more high-quality, prospective research is needed to clarify its role and effectiveness. The presentation underscores the importance of adhering to established guidelines and engaging in further studies to improve treatment standards.