Journal article
Establishing Consensus for Mohs Micrographic Surgical Techniques in the Treatment of Melanoma in Situ for Future Clinical Trials: A Modified Delphi Study
Journal of the National Comprehensive Cancer Network, Vol.22(8), e247036
10/2024
DOI: 10.6004/jnccn.2024.7036
PMCID: PMC12717678
PMID: 39079545
Abstract
Background : Mohs micrographic surgery (MMS) is a promising treatment modality for melanoma in situ (MIS). However, variations in surgical technique limit the generalizability of existing data and may impede future study of MMS in clinical trials. Methods: A modified Delphi method was selected to establish consensus on optimal MMS techniques for treating MIS in future clinical trials. The Delphi method was selected due to the limited current data, the wide range of techniques used in the field, and the intention to establish a standardized technique for future clinical trials. A literature review and interviews with experienced MMS surgeons were performed to identify dimensions of the MMS technique for MIS that (1) likely impacted costs or outcomes of the procedure, and (2) showed significant variability between surgeons. A total of 8 dimensions of technical variation were selected. The Delphi process consisted of 2 rounds of voting and commentary, during which 44 expert Mohs surgeons across the United States rated their agreement with specific recommendations using a Likert scale. Results: Five of eight recommendations achieved consensus in Round 1. All 3 of the remaining recommendations achieved consensus in Round 2. Techniques achieving consensus in Round 1 included the use of a starting peripheral margin of ≤5 mm, application of immunohistochemistry, frozen tissue processing, and resecting to the depth of subcutaneous fat. Consensus on the use of Wood’s lamp, dermatoscope, and negative tissue controls was established in Round 2. Conclusions: This study generated 8 consensus recommendations intended to offer guidance for Mohs surgeons treating MIS. The adoption of these recommendations will promote standardization to facilitate comparisons of aggregate data in multicenter clinical trials.
Details
- Title: Subtitle
- Establishing Consensus for Mohs Micrographic Surgical Techniques in the Treatment of Melanoma in Situ for Future Clinical Trials: A Modified Delphi Study
- Creators
- Kristen K. Curtis - Case Western Reserve UniversityNathan J. Fakult - Case Western Reserve UniversityJennifer L. Strunck - Oregon Health & Science UniversitySumaira Z. Aasi - Stanford UniversityChristine S. Ahn - Wake Forest UniversityMurad Alam - Northwestern UniversityAnna A. Bar - Oregon Health & Science UniversityRamona Behshad - SSM Health CareChristopher K. Bichakjian - University of MichiganDiana Bolotin - University of ChicagoSusan L. Boone - University of California, DavisJeremy S. Bordeaux - Case Western Reserve UniversityJerry D. Brewer - Mayo Clinic in ArizonaDavid R. Carr - The Ohio State UniversityJohn A. Carucci - New York UniversityJason R. Castillo - UCLA Medical CenterSean R. Christensen - Yale UniversityMelanie A. Clark - Medical College of WisconsinLindsey K. Collins - University of Oklahoma Health Sciences CenterAddison M. Demer - Mayo Clinic in ArizonaDaniel B. Eisen - University of California, DavisHao Feng - University of ConnecticutBahar F. Firoz - Rutgers, The State University of New JerseyRoy C. Grekin - University of California, San FranciscoJason M. Hirshburg - University of Oklahoma Health Sciences CenterTodd E. Holmes - University of Vermont Medical CenterConway C. Huang - University of Alabama at BirminghamThomas A. Jennings - University of Arkansas for Medical SciencesShang I. Brian Jiang - University of California San DiegoSailesh Konda - Florida CollegeJustin J. Leitenberger - Oregon Health & Science UniversityJesse M. Lewin - Icahn School of Medicine at Mount SinaiIan A. Maher - University of MinnesotaElise Ng - Johns Hopkins MedicineIda F. Orengo - Baylor College of MedicineFaramarz H. Samie - Columbia University Irving Medical CenterDrew K. Saylor - University of California, San FranciscoVictoria Rose Sharon - Hofstra UniversityTeo Soleymani - University of California, Los AngelesSusan M. Swetter - Stanford UniversityJesalyn A. Tate - University of Kansas Medical CenterMarta J. Van Beek - University of IowaNahid Y. Vidal - Mayo Clinic in ArizonaAlok Vij - Cleveland ClinicAshley Wysong - University of Nebraska at OmahaYaohui Gloria Xu - University of Wisconsin–MadisonBryan T. Carroll - Case Western Reserve UniversityWesley Y. Yu - Oregon Health & Science University
- Resource Type
- Journal article
- Publication Details
- Journal of the National Comprehensive Cancer Network, Vol.22(8), e247036
- DOI
- 10.6004/jnccn.2024.7036
- PMID
- 39079545
- PMCID
- PMC12717678
- NLM abbreviation
- J Natl Compr Canc Netw
- ISSN
- 1540-1405
- eISSN
- 1540-1413
- Language
- English
- Electronic publication date
- 07/30/2024
- Date published
- 10/2024
- Academic Unit
- Dermatology
- Record Identifier
- 9984691554602771
Metrics
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