Scientific publications

Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer- Basal Cell Carcinoma or Squamous Cell Carcinoma- Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study. Scientific Publication

May 1, 2022 | Magazine: Actas Dermosifiliográficas

Román Miñano Medrano  1 , José L López Estebaranz  2 , Onofre Sanmartin-Jiménez  3 , Joan R Garcés  4 , Manuel A Rodríguez-Prieto  5 , Eva Vilarrasa-Rull  4 , Esther de Eusebio-Murillo  6 , Begoña Escutia-Muñoz  7 , Ángeles Flórez-Menéndez  8 , Juan L Artola-Igarza  9 , Alberto Alfaro-Rubio  10 , Pedro Redondo  11 , Yolanda Delgado-Jiménez  12 , Julia M Sánchez-Schmidt  13 , Irati Allende-Markixana  14 , María L Alonso-Pacheco  15 , Beatriz García-Bracamonte  16 , Pablo de la Cueva-Dobao  17 , Raquel Navarro-Tejedor  18 , Cristina Ciudad-Blanco  19 , Lucía Carnero-González  20 , Hugo Vázquez-Veiga  21 , Natividad Cano-Martínez  22 , Verónica Ruiz-Salas  4 , Pedro Sánchez-Sambucety  5 , Rafael Botella-Estrada  7 , Beatriz González-Sixto  8 , Antonio Martorell-Calatayud  10 , Pilar Gil  11 , Victoriano Morales-Gordillo  23 , Agustí Toll-Abelló  13 , Izascun Ocerin-Guerra  14 , Matías Mayor-Arenal  15 , Ricardo Suárez-Fernández  24 , Laura Sainz-Gaspar  21 , Miguel A Descalzo  25 , Ignacio Garcia-Doval  25


Background: Patients diagnosed of keratinocyte cancer (basal cell carcinoma and cutaneous squamous cell carcinoma) or non-melanoma skin cancer (NMSC) have a higher risk of develop a second cutaneous malignant neoplasm.

Objective: Our aim was to describe the frequency, incidence rate and risk factor predisposing to develop a second neoplasm in a patients cohort treated with Mohs Micrographic Surgery (MMS).

Methods: Prospective cohort of consecutive patients undergoing MMS in 22 representative Spanish centres (July 2013-February 2020) REGEMOHS. Variables analysed in a logistic multilevel multivariate analysis included characteristic of patients, frequency of second cutaneous neoplasm, incidence rate and risk factors.

Results: 4768 patients underwent MMS: 4397 (92%) basal cell carcinoma and 371 (8%) cutaneous squamous cell carcinoma. Mean follow up was 2,4 years. A second malignant neoplasm was diagnosed in 1201 patients (25%). 1013 (21%) were basal cell carcinomas; 154 (3%) cutaneous squamous cell carcinoma and 20 (0,4) melanomas. Incidence rate was 107 (101-113) cases per 1000 person-year for any tumour; 90 (85-96) basal cell carcinoma, 14 (12-16) cutaneous squamous cell carcinoma and 2 (1-3) melanoma. Significant risk factors for developing a second cutaneous malignant neoplasm were previous history of multiple tumours before diagnosis (RR: 4.6 95% CI: 2.9-7.1), immunosuppression (RR: 2.1 95% CI: 4-3.1) and male (RR: 1.6 95% CI: 1.4-1.9).

Conclusion: Patients diagnosed of keratinocyte carcinoma who underwent MMS have a higher risk for developing a second cutaneous malignant neoplasm. These are more frequent in patients with previous history of multiple neoplasm, immunosuppression and males.

CITATION  Actas Dermosifiliogr. 2022 May;113(5):T451-T458. doi: 10.1016/j.ad.2022.01.035. Epub 2022 Apr 15.

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