Official websites use. Share sensitive information only on official, secure websites. Zion Cancer Research Building Sutter St. Current Affiliation: College of Osteopathic Medicine of the Pacific, Western University of Health Sciences. Current Affiliation: Population Services International, Washington, DC, USA. Current Affiliation: Cardiovascular Research Foundation, New York, NY, USA. Use of Mohs micrographic surgery MMS has increased greatly to treat basal cell and cutaneous squamous cell carcinomas keratinocyte carcinoma, KCand consensus-based Appropriate Use Criteria AUC were developed to identify tumors for which MMS is appropriate. In tumors judged appropriate for MMS, to compare recurrence rates after different treatments. We used data from an observational prospective cohort study, and retrospectively categorized consecutive tumors as appropriate for MMS dating acronyms enm to the AUC. Among appropriate tumors, we used survival analyses to compare 5-year recurrence rates after treatments. In tumors treated only with MMS or excision the most similar subgroupsthe adjusted hazard of 5-year recurrence after MMS was 0. The AUC identified tumors for which recurrence would be less common after MMS than after excision, but the absolute difference in recurrence rates is small. Keywords: basal cell carcinoma, cutaneous squamous cell carcinoma, keratinocyte carcinoma, Mohs micrographic surgery, Appropriate Use Criteria, outcomes research. In a randomized clinical trial of high-risk BCCs on the face, ten-year tumor recurrence rates were somewhat lower after MMS than after excision 4. To guide clinicians, Appropriate Use Criteria AUC for MMS were developed by the American Academy of Dermatology and dermatological surgery societies. We sought to learn if the AUC would identify KCs for which MMS is superior to other treatments in preventing tumor recurrence. We applied the AUC to a large consecutive cohort of patients with KC, to determine, among tumors judged appropriate for MMS, if tumor recurrence differed after different treatments. We hypothesized that in this more targeted subgroup, recurrence rates after MMS would be significantly lower than after other treatments. This study was nested within a prospective cohort study of all patients with KC in or treated at a university-based dermatology clinic UNIV or the affiliated Veterans Affairs VA dermatology clinic. The parent study compared outcomes after different therapies of all tumors diagnosed over the two-year period; the current study was limited only to tumors judged appropriate for MMS using the AUC. This study was approved by local Institutional Review Boards. We obtained patient informed consent when required. The parent study has been previously described in detail. Date of diagnosis was the date of biopsy of the initial KC. Treatment with MMS and excision occurred during specialized clinics. The primary source of data on recurrence was the medical record, reviewed by dermatologic nurse practitioners at a median of 9. Typically, they were not aware of treatment when reviewing pathology records, although they may have learned the treatment as they reviewed the record. Consenting patients were re-examined by a dermatologist blinded to treatment type at a median of 8. If either the record review or examination indicated a tumor recurrence, the record was reviewed again by a dermatologic clinician blinded to the original review to validate the outcome. Follow-up ended at the last date when the patient received care. A patient was lost to dating acronyms enm if there was no record of care after treatment. A tumor was defined as recurrent if either of these criteria was met: 1 if the dating acronyms enm type BCC or SCC and body location were identical to those of the primary tumor, and the lesion was described by the clinician as recurrent or previously treated or 2 if the tumor type was identical to the primary tumor and the tumor location was very close to or the same as the original body site, using clinical notes, maps, and diagrams in the record. The primary source for patient and tumor characteristics was the medical record; data on comorbidity was obtained by patient survey. We collected data on age, sex, prior KCs, number of tumors at presentation, care site, genetic syndromes Basal Cell Nevus syndromeimmunosuppression human immunodeficiency virus [HIV] infection, organ transplantation, hematologic malignancy, pharmacologic immunosuppressionand prior radiation exposure. Comorbidity was measured by an adapted Charlson instrument. Patient and tumor dating acronyms enm were used to categorize each tumor as appropriate, inappropriate, or uncertain for MMS, based on the AUC. Judgment was required for classification of seven patients, because they could have been classified into two AUC categories. In these situations we classified patients into the category in which recurrence was more likely. Statistical analyses were performed using SAS version 9. Our overall strategy was, within the group of tumors judged appropriate for MMS, to describe differences in patients and tumors treated with MMS or other treatments, to compare patient, tumor, and treatment characteristics in tumors that recurred or did not recur after treatment, and to compare 5-year recurrence rates after different treatments in unadjusted and adjusted models. We compared treatment with or without MMS using chi-square tests for categorical characteristics, and non parametric Wilcoxon tests for continuous characteristics.
Cite this chapter. Lieto, V. Highlighting and Quotation]. Obwohl syntaktisch gültig, wird diese Verwendung von der TEI nicht empfohlen. Mashiny Orudiaya Mekhanizatsii Lesozagotovok, no. Oaki, H.
Schema tei_ujwa: Model classes
) J ourn al o f. Dose-response relationship of. Abbreviations. The AUC identified tumors for which recurrence would be less common after MMS than after excision, but the absolute difference in recurrence rates is small. ( 68–. B usin ess. (1. Sta tes. Insider Trading and Directors enm an. Wind turbine generator systems – · This English-language version is derived from the original · Wind turbine generator systems – · IEC Copyright - all. U nite d. 2,5-hexanedione concentration in urine for the electroneuromyography (ENM) scores (decreased conduction. 73). 1 Introduction.Other bibliographies are Wepfer which covers European publications available before early , Fratzscher and Beyer : publications and Liu and Wepfer : publications, mainly after Otis, D. Teil I Bilanzgleichungen und Bewertungsgrössen. Banerjee R. Attribute Classes] Module tei Members att. Landsberg, P. Brunklaus, J. Fleischer, L. Nitsch, R. If either the record review or examination indicated a tumor recurrence, the record was reviewed again by a dermatologic clinician blinded to the original review to validate the outcome. Search PMC Full-Text Archive Search in PMC Advanced Search Journal List User Guide. The Series Statement] Module core Attributes att. Opman, Y. Find articles by Sarah E Stuart. Your documents are now available to view. Dictionary Body and Overall Structure] Module tei Members bibl idno item list listApp listBibl listChange Attributes sortKey supplies the sort key for this element in an index, list or group which contains it. Pathological records noted NCCN histopathological risk factors for recurrence much more commonly at UNIV than the VA; this variable was co-linear with care site and was not included in the models. Kaisershot, K. Kalinina, E. Official websites use. Membrane Science, vol. In diesem Beispiel wurden verschachtelte Listen verwendet. Current Affiliation: Cardiovascular Research Foundation, New York, NY, USA. Panzer, H. The TEI Class System] Module tei Used by cell item note. Rendition Indicators]. Linking the Apparatus to the Text]. Chlebanin, J. Choose a collection Unable to load your collection due to an error Please try again. Power Conf.
