Improved Overall Survival of Melanoma of the Head and Neck Treated with Mohs Micrographic Surgery versus Wide Local Excision

Abstract Background Optimal surgical management for melanoma of the head and neck remains controversial. Objective Assess outcomes for melanomas of the head and neck treated with Mohs micrographic surgery (MMS) vs wide local excision (WLE) from the National Cancer Database (NCDB). Methods Head and neck melanoma data from the NCDB from years 2004-2015 were analyzed. Results 50,397 head and neck melanomas were reviewed. 3,510 (7%) were treated with MMS and 46,887 (93%) with WLE. After controlling for potential confounding variables, patients treated with MMS were more likely to survive after 5-years than patients treated with WLE (Hazard ratio 1.181, 95% confidence interval 1.083-1.288, p Limitations Database study, limited number of MMS treated melanomas. Conclusion MMS is a valid treatment option for melanoma of the head and neck; NCDB data suggests that MMS may confer a survival benefit over WLE.