Treatment Patterns, Outcomes, and Patient Satisfaction of Epidermal Superficial Non-Melanoma Skin Cancer at an Academic Dermatologic Surgery Center

Abstract

Epidermally-limited non melanoma skin cancer (NMSC), defined as superficial basal cell carcinoma and squamous cell carcinomas in-situ, is associated with significant morbidity and cost. This study examined the patterns, outcomes, and satisfaction for NMSC treatment. The study consisted of a retrospective single institution analysis of 550 patients diagnosed with 678 NMSCs treated from Jan 2008 to Mar 2014. A satisfaction survey was then administered to 142 patients from May 2014 to Jun 2014. A total of 329 tumors (49%) were treated with Mohs micrographic surgery (MMS), 292 tumors (43%) with topical medication (TM), and 57 tumors (8%) with cryotherapy (CT). Of the 11 clinical recurrences (2%), 7 (64%) were treated with TM, 2 (18%) with MMS, and 2 (18%) with CT. The difference in recurrence risk (3.3% non-MMS vs. 0.7% MMS) was not significant. Independent predictors for recurrence were tumor diameter greater than 2.0 cm (HR, 5.1 [95% CI, 1.3-19.5]) and immunosuppression (3.6 [1.0-12.5]). Of patients surveyed, 97% who received MMS were satisfied/very satisfied versus 91% who received non-MMS treatment (p=0.092). This study indicates that surgical and non-surgical treatments for NMSC may have more equivalent efficacy than previously reported and a large majority of patients are satisfied with their treatment.