Microscopically controlled excision of skin cancer

Objective: To describe the technique of microscopically controlled excision of skin cancer (Moh's surgery) and to review the early experience of the use of this technique at Royal Prince Alfred Hospital. Design: A review of 170 clinical records of patients with 198 skin malignancies treated by microscopically controlled excision from 1981 to 1983. Patients: Long term follow-up of 148 patients with 170 lesions was possible. An analysis of these patients' sex and age, and the site, size and histopathological diagnosis of their lesions was carried out. Interventions: All patients underwent microscopically controlled excision of their skin cancer. Analysis of the operative procedure revealed an average of 2.1 excision stages and 14.8 blocks examined by frozen section for each tumour. Results: The overall cure rate was 97.1% for this group of patients. This rate is comparable with that of other centres performing this procedure. Conclusions: Microscopically controlled excision offers an excellent cure rate for skin cancers, especially recurrent, difficult basal cell carcinomas In areas known to be at high risk for recurrence, for example, central areas on the face. The application of this technique to selected patients and tumours offers a higher cure rate than conventional treatment methods.