Risk Factors and Rate of Recurrence after Mohs Surgery in Basal Cell and Squamous Cell Carcinomas: A Nationwide Prospective Cohort (REGESMOHS, Spanish Registry of Mohs Surgery)

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Cited 14 times in Web of Science logo

Cited 1 times in Europe PMC logo

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Grant support

REGESMOHS (Registro Espanol de Cirugia de Mohs) was promoted by Fundacion Piel Sana AEDV, with financial support from Roche Pharma. This publication has received unrestricted financial support from Sun Pharma. Roche Pharma and Sun Pharma have not participated in the design, analysis, or interpretation of the data.

Impact on the Sustainable Development Goals (SDGs)

Analysis of institutional authors

Toll-Abello, AgustiAuthor

June 5, 2025

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Article

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Publicated to:Acta Dermato-Venereologica. 101 adv00602- - 2021-11-01 101(), DOI: 10.2340/actadv.v101.544

Authors: Tomas-Velazquez, Alejandra; Sanmartin-Jimenez, Onofre; Garces, Joan R; Rodriguez-Prieto, Manuel A; Ruiz-Salas, Veronica; De Eusebio-Murillo, Esther; Minano-Medrano, Roman; Escutia-Munoz, Begona; Florez-Menendez, Angeles; Artola-Igarza, Juan L; Alfaro-Rubio, Alberto; Gil, Pilar; Delgado-Jimenez, Yolanda; Sanchez-Schmidt, Julia M; Allende-Markixana, Irati; Alonso-Pacheco, Maria L; Garcia-Bracamonte, Beatriz; De la Cueva-Dobao, Pablo; Navarro-Tejedor, Raquel; Ciudad-Blanco, Cristina; Carnero-Gonzalez, Lucia; Vazquez-Veiga, Hugo; Cano-Martinez, Natividad; Vilarrasa-Rull, Eva; Sanchez-Sambucety, Pedro; Lopez-Estebaranz, Jose L; Botella-Estrada, Rafael; Gonzalez-Sixto, Beatriz; Martorell-Calatayud, Antonio; Morales-Gordillo, Victoriano; Toll-Abello, Agusti; Ocerin-Guerra, Izascun; Mayor-Arenal, Matias; Suarez-Fernandez, Ricardo; Sainz-Gaspar, Laura; Descalzo, Miguel A; Garcia-Doval, Ignacio; Redondo, Pedro

Affiliations

Clin Univ Navarra, Pamplona, Spain - Author

Complejo Asistencial Univ Leon, Leon, Spain - Author

Complejo Hosp Univ Guadalajara, Guadalajara, Spain - Author

Complex Hosp Univ Vigo, Vigo, Spain - Author

Complexo Hosp Univ Santiago, Santiago De Compostela, Spain - Author

Complexo Univ Hosp Pontevedra, Pontevedra, Spain - Author

Ctr Med Teknon, Barcelona, Spain - Author

Fdn Piel Sana, Acad Espanola Dermatol, Madrid, Spain - Author

Hosp del Mar, Barcelona, Spain - Author

Hosp Galdakao, Galdakao, Spain - Author

Hosp Gen Univ Gregorio Maranon, Madrid, Spain - Author

Hosp Infanta Leonor, Madrid, Spain - Author

Hosp La Paz, Madrid, Spain - Author

Hosp La Zarzuela, Madrid, Spain - Author

Hosp Manises, Valencia, Spain - Author

Hosp Santa Creu & Sant Pau, Barcelona, Spain - Author

Hosp Univ Araba, Vitoria, Spain - Author

Hosp Univ Cruces, Baracaldo, Spain - Author

Hosp Univ Doce Octubre, Madrid, Spain - Author

Hosp Univ Fdn Akoroon, Madrid, Spain - Author

Hosp Univ La Fe, Valencia, Spain - Author

Hosp Univ La Princesa, Madrid, Spain - Author

Hosp Univ Quiron Salud, Madrid, Spain - Author

Inst Valenciano Onool, Valencia, Spain - Author

Abstract

Randomized studies to assess the efficacy of Mohs micrographic surgery in basal cell and squamous cell carcinomas are limited by methodological and ethical issues and a lack of long follow-up periods. This study presents the "real-life" results of a nationwide 7-years cohort on basal cell carcinoma and squamous cell carcinoma treated with Mohs micrographic surgery. A prospective cohort was conducted in 22 Spanish centres (from July 2013 to February 2020) and a multivariate analysis, including characteristics of patients, tumours, surgeries and follow-up, was performed. A total of 4,402 patients followed up for 12,111 patientyears for basal cell carcinoma, and 371 patients with 915 patient-years of follow-up for squamous cell carcinoma were recruited. Risk factors for recurrence included age, non-primary tumours and more stages or unfinished surgeries for both tumours, and immunosuppression for squamous cell carcinoma. Incidence rates of recurrence were 1.3 per 100 person-years for basal cell carcinoma (95% confidence interval 1.1-1.5) and 4.5 for squamous cell carcinoma (95% confidence interval 3.3-6.1), being constant over time (0-5 years). In conclusion, follow-up strategies should be equally intense for at least the first 5 years, with special attention paid to squamous cell carcinoma (especially in immunosuppressed patients), elderly patients, non-primary tumours, and those procedures requiring more stages, or unfinished surgeries.

Keywords

AustraliaBasal cell carcinomaChemosurgeryDermatologyDiagnosisExperienceFaceGood health and well-beingLocal recurrenceMicrographic surgeryMohs surgeryRecurrenceRisk factorSquamous cell carcinomaSurgical excisionSurviva

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Acta Dermato-Venereologica due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category .

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.52. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

Field Citation Ratio (FCR) from Dimensions: 6.11 (source consulted: Dimensions Oct 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-10-10, the following number of citations:

WoS: 14
Europe PMC: 1
Open Alex: 12