Predictors of reconstruction with Mohs removal of nonmelanoma skin cancers

OBJECTIVES/HYPOTHESIS: To assess clinico-demographic characteristics available before Mohs removal of nonmelanoma skin cancers of the head and neck as predictors of the need for extensive reconstruction. STUDY DESIGN: Retrospective chart review. METHODS: Variables examined were age, sex, race, marital status, past medical history, family history of skin cancer, use of tobacco or alcohol, history of radiation therapy, history of reconstruction, history of immunosuppression, tumor size, tumor site, histology, primary or recurrent tumor, number of tumors treated, and history and location of previous skin tumors. Univariate and multivariate analyses were performed assessing the need for extensive reconstruction after skin tumor removal as an outcome variable. RESULTS: Age, tumor site, and a past history of reconstruction after resection of a previous skin tumor were characteristics identified as being predictive of the need for advanced reconstruction. The most common tumor locations that required postablation reconstruction were the nose (228 tumors) and the ear (148 tumors). Thirty-six of recurrent tumors and 32% of primary tumors were reconstructed. The odds of a female requiring reconstruction were 2:1. The mean ages were 64.3 years in the reconstruction group and 67.2 years in those not reconstructed. Size of tumor did not correlate with the need for reconstruction. CONCLUSIONS: Patient's age, skin tumor location, and past history of extensive reconstruction after previous resection of skin tumor are patient-specific characteristics available before tumor resection that predict the need for advanced reconstruction in patients undergoing Mohs micrographic surgery removal of skin cancers.