Mohs хирургия базалиом?

Цитата:

Сообщение от Ophthalmist (Сообщение 2674567)

. Преимущество Mohs операций для иссечения базалиом на лице онкологами и дерматологами-хирургами форума оспаривается?

Все зависит как/с каких позиций Вы оцениваете, обозреватели из Кокрэйна не нашли никаких сравнительных исследований:
BCC is the commonest skin cancer and the most common cancer in people of white origin. It is usually seen on the sun exposed parts of the body like the face, neck, head and ears. Untreated lesions can slowly eat away the surrounding skin and hence they are also called "rodent ulcers".

The commonest treatment for BCC is surgery. This is traditionally achieved by surgical excision (SE) which involves cutting away the BCC, along with a margin of normal appearing skin around it to ensure complete removal of the cancer and to reduce the risk of recurrence.

Another type of surgery is Mohs micrographic surgery (MMS). This involves the removal of the skin tumour after colour coding the edges. This is then examined under the microscope to see if all the BCC has been removed. If any residual BCC is left at any particular edge further skin is removed from only that localised area by using the colour coding, and examined under the microscope. This process is continued until all the BCC is removed. This ensures complete tumour removal and spares normal tissue in the other directions.

MMS is considered the better alternative for treatment of certain types of BCC arising in the eyelids because it has the highest chance of curing the disease and minimises the size of the defect that needs to be repaired.

Unfortunately, this treatment is not available everywhere and not always employed because of practical limitations in the service delivery.

Surgical excision is thought to be a cheaper option as it does not require the special training, multiple procedures, and money involved in setting up and running a MMS service. However, longer duration of follow up, greater surgical morbidity and the cost of dealing with recurrences may over time significantly increase the cost of SE.

No reliable conclusions could be reached regarding which method of treatment (SE or MMS) resulted in a lower recurrence or complication rate for periocular BCC. No studies were found comparing the cost of either method directly. [Ссылки могут видеть только зарегистрированные пользователи. ]

вот здесь нашли разницу, но для этого потребовалось более 5 лет (10 лет) наблюдений:
Eur J Cancer. 2014 Nov;50(17):3011-20.
Surgical excision versus Mohs' micrographic surgery for basal cell carcinoma of the face: A randomised clinical trial with 10 year follow-up.
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данная работа была опубликована уже после того обсуждения на РМС