AAFPRS046 - The Impact of Sociodemographic Factors on Mohs Micrographic Surgery and Reconstruction
Wednesday, April 27, 2022
4:40 PM – 4:45 PM CT
Location: Landmark D
Isabelle Gengler, MD; Susie Min, BS; Tyler Bauman, MD; Adam McCann, MD; Peter Knabel, DO; Ryan Collar, MD MBA; Tsung-yen Hsieh, MD
Division of Facial Plastic and reconstructive surgery (Ryan Collar, Tsung-yen Hsieh)
Department of otolaryngology head and neck surgery (Isabelle Gengler, Adam McCann)
Department of dermatology (Tyler Bauman, Peter Knabel)
University of Cincinnati College of Medicine (Susie Min)
Resident University of Cincinnati Cincinnati, Ohio
Background: Mohs micrographic surgery (MMS) is used to resect basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the face. This is followed by surgical reconstruction to treat the resultant defect. The impact of sociodemographic factors on surgical and oncologic outcomes has not been thoroughly evaluated.
Study objective: To identify sociodemographic factors of patients with skin cancers of the face and their correlation with tumor size, defect size, extent of surgical repair, and post-operative outcomes.
Method: A retrospective review was conducted of 400 patients with BCC or SCC of the face who underwent MMS followed by reconstruction over a five-year period. Patient demographics, medical history, surgical and oncologic outcomes were collected.
Results: The study population included 400 patients. Increased Mohs defect size was associated with SCC (p 0.0039), chronic skin conditions (p 0.0005), immunosuppression/neoplasia (p 0.0116), history of SCC (p 0.0148), lack of insurance coverage (p 0.045), and increased distance from the treatment facility (p 0.038). Patients were more likely to have post-procedure complications if they had larger Mohs defect (p< 0.0001), more extensive surgical repair (p< 0.001), larger tumor size at presentation (p<0.001), surgical repair requiring a cartilage graft (p<0.0004), or a lower income (p<0.013).
Conclusion: In patients with skin cancers of the face, sociodemographic factors can impact tumor size, defect size, extent of surgical repair, and post-operative outcomes. Targeted interventions on identified risk factors can increase patient awareness with a focus on prevention and early detection of malignancies, which has potential to improve overall patient outcomes.