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Two retrospective cohort analyses evaluated MM on the face, scalp, and neck, and then MIS on the same anatomic regions. WLE showed higher secondary malignant neoplasms involving head and neck lymph nodes and additional spread to bone, lung, and brain in MM. Similar higher secondary rates were seen across WLE in the MIS analysis. Postoperative complication rates were comparable between groups in both analyses.",{"@graph":69,"@context":121},[70,84,104],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/outcomes-of-mohs-micrographic-surgery-compared-to-wide-local-excision-for-malignant-melanoma-and-melanoma-in-situ/351692/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":98,"encodingFormat":97,"isAccessibleForFree":99,"interactionStatistic":100},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/outcomes-of-mohs-micrographic-surgery-compared-to-wide-local-excision-for-malignant-melanoma-and-melanoma-in-situ/351692.png","ImageObject",300,407,{"name":92,"@type":93},"Pentious","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-22",true,{"@type":101,"interactionType":102,"userInteractionCount":8},"InteractionCounter",{"@type":103},"ViewAction",{"@type":105,"mainEntity":106},"FAQPage",[107,113,117],{"name":108,"@type":109,"acceptedAnswer":110},"How were MMS and WLE compared in this study?","Question",{"text":111,"@type":112},"Two retrospective cohort analyses were performed in the TriNetX Research Network: one compared WLE versus MMS for malignant melanoma, and the other compared them for melanoma in situ, both restricted to the face, scalp, and neck.","Answer",{"name":114,"@type":109,"acceptedAnswer":115},"What did the study find about secondary malignant neoplasms?",{"text":116,"@type":112},"For MM, WLE was associated with a significantly higher incidence of secondary and unspecified malignant neoplasms of head and neck lymph nodes and secondary malignancies of bone, lung, and brain. For MIS, WLE showed higher rates of secondary malignant neoplasms across head and neck, bone, lung, and brain.",{"name":118,"@type":109,"acceptedAnswer":119},"Were postoperative complication rates different between MMS and WLE?",{"text":120,"@type":112},"No. Postoperative complication rates were similar between the MMS and WLE groups in both the MM and MIS analyses.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},351692,1790105047,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":138,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":67,"update_tm":142,"read_time":143},1374404730887,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review began 11/09/2025  \nReview ended 04/13/2026  \nPublished 04/20/2026  \n© Copyright 2026  \nGoldstein et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.107415  \nOpen Access Original Article  \nOutcomes of Mohs Micrographic Surgery Compared to Wide Local Excision for Malignant Melanoma and Melanoma In Situ  \nDora R. Goldstein 1 , Ryan S. Koch 2 , Radwa Emam 3, Kevin T. Nguyen 4 , Justin Raman 5, Floyd A. Pirtle 5, Leor Daniel Goldstein 6 , Michelle Tarbox 5, Kritin K. Verma 4, Alba Posligua 5  \n1. School of Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA 2. Department of Internal Medicine, Baylor Scott & White Medical Center-Temple, Temple, USA 3. College of Medicine, Texas A&M College of Medicine, Bryan, USA 4. School of Medicine, Texas Tech University Health Sciences Center, Lubbock, USA 5. Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, USA 6. Department of Public Health, The University of Texas at Austin, Austin, USA  \nCorresponding author: Kritin K. Verma, [kkverma.research@gmail.com](kkverma.research@gmail.com)  \nAbstract  \nMohs micrographic surgery (MMS), traditionally used for non-melanoma skin cancers, has been used for some cases of melanoma. Using the TriNetX (TriNetX, LLC, Cambridge, MA, USA) database, two analyses were performed. The first compared wide local excision (WLE) and MMS for the management of malignant melanoma (MM) of the face, scalp, and neck. The second analysis compared WLE and melanoma in situ (MIS) of the same anatomical areas. WLE was associated with a significantly higher incidence of secondary and unspecified malignant neoplasms of the lymph nodes of the head and neck and secondary malignant neoplasm of the bone, lung, and brain in the MM analysis. In the MIS analysis, WLE was found to have higher rates of secondary malignant neoplasms of the head and neck, bone, lung, and brain. The postoperative complication rates were similar between the MMS and WLE groups in both analyses.  \nCategories: Dermatology  \nKeywords: facial skin cancer, melanoma, mohs micrographic surgery, surgical outcomes, wide local excision  \nIntroduction  \nAs the incidence of melanoma continues to rise yearly, the need for optimized surgical treatments that preserve tissue, especially malignancies located on sensitive areas such as the head, genitals, and feet, becomes even more important [1] . Mohs micrographic surgery (MMS), traditionally used for non-melanoma skin cancers, has been used for cases of melanoma in situ (MIS), lentigo maligna, and thin lesions [1] . Mohs surgeons can achieve histologically clear margins with the use of immunohistochemical stains such as MART-1, SOX10, and human melanoma black-45 [1] . However, wide local excision (WLE) remains the standard surgical treatment for melanoma for all stages [2] . This study aims to compare postoperative complication rates of MMS vs. WLE, assess relative risks of secondary malignant neoplasms after each procedure, and evaluate whether MMS is comparable or superior in oncologic outcomes for malignant melanoma (MM) and MIS ofthe head and neck.  \nMaterials And Methods  \nUsing the TriNetX Research Network (TriNetX, LLC, Cambridge, MA, USA), two retrospective cohort analyses were conducted to compare outcomes between patients undergoing WLE and MMS for melanoma of the face, scalp, and neck. The first analysis included individuals diagnosed with MM, and the second focused on MIS ofthe same anatomical regions.  \nCohorts were identified using ICD-10 diagnostic and procedural codes [3], and patients were stratified based on whether they received WLE (Codes: 11640-11646) or MMS (Codes: 17311-17315) as their primary treatment. Subjects with outcomes prior t","cbCailQ3NR5U4xUn","https://ap.wps.com/l/cbCailQ3NR5U4xUn","pdf",128263,"English","# Abstract\n# Introduction\n# Materials And Methods\n## Study design and cohorts\n## Statistical analysis\n# Results","[{\"question\":\"How were MMS and WLE compared in this study?\",\"answer\":\"Two retrospective cohort analyses were performed in the TriNetX Research Network: one compared WLE versus MMS for malignant melanoma, and the other compared them for melanoma in situ, both restricted to the face, scalp, and neck.\"},{\"question\":\"What did the study find about secondary malignant neoplasms?\",\"answer\":\"For MM, WLE was associated with a significantly higher incidence of secondary and unspecified malignant neoplasms of head and neck lymph nodes and secondary malignancies of bone, lung, and brain. For MIS, WLE showed higher rates of secondary malignant neoplasms across head and neck, bone, lung, and brain.\"},{\"question\":\"Were postoperative complication rates different between MMS and WLE?\",\"answer\":\"No. Postoperative complication rates were similar between the MMS and WLE groups in both the MM and MIS analyses.\"}]","Outcomes of Mohs Micrographic Surgery Compared to Wide Local Excision for Malignant Melanoma and Melanoma In Situ | PDF",1790095365,18]