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Mohs Surgery Outperforms Wide Local Excision in High-Grade Squamous Cell Skin Cancer Treatment

Synopsis by Lewis Flint, MD, FACS

June 10, 2025

acs-store-journalperiodical.jpg

Wang DM, Vestita M, Murad FG, et al. Mohs Surgery vs Wide Local Excision in Primary High-Stage Cutaneous Squamous Cell Carcinoma. JAMA Dermatol. 2025;161(5):508–514.

Mohs micrographic surgery uses multiple pathologic samples obtained at the time of skin cancer excision to determine complete removal of all abnormal tissue.

This article reported outcomes of a retrospective cohort study (n = 216) that compared rates of recurrence or metastasis in patients with high-grade squamous cell skin cancers who were matched for risk using propensity scoring and were treated with either Mohs surgery or wide local excision.

Median follow up was 33 months. Local recurrence (19.8% vs 9.6%) and metastasis (17.9% vs 11%) were observed more often in patients treated with wide local excision.

The authors recommended that Mohs surgery or similar techniques be used as the primary means of treating high-grade squamous cell skin cancer.

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