MOHS Patients Can Reliably Estimate Preoperative Non-Melanoma Skin Cancer Size.

Skinmed Pub Date : 2024-12-31 eCollection Date: 2024-01-01
Gabrielle M Rivin, Spencer Dunaway, Matthew Olagbenro, Zachary Carter, Alan B Fleischer, Scott A Neltner
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Abstract

As the presurgical size and anatomic location of non-melanoma skin cancer correlates to the complexity of Mohs micrographic surgery (MMS), patients are frequently asked to self-report their preoperative tumor size to aid in efficient scheduling and triage. We aimed to assess the accuracy of patient's self-reported lesion measurements prior to MMS by comparing patient's estimates of lesion size to the measurements taken by a Mohs surgeon. We conducted a retrospective chart review of 1,000 patients who underwent MMS and self-reported their lesion size at a preoperative telehealth visit. The patients reported their lesion size in one dimension (1D)/two dimensions (2D) or using a pencil eraser as a size reference. Patients demonstrated excellent reliability (intra-class correlation coefficient [ICC]: 0.916) while reporting their lesion size in two dimensions, and moderate reliability (ICC: 0.644) while reporting their lesion size in one dimension. Patients had slight agreement (κ = 0.178) with the surgeon's preoperative measurement while using a pencil eraser as a size reference. Dermatology practices must be encouraged to utilize telehealth to obtain presurgical size estimates from patients using 1D or 2D size measurements. By utilizing presurgical size estimates, surgeons can better triage and schedule patients to provide appropriate anticipatory guidance to patients and their caretakers.

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MOHS患者可以可靠地估计术前非黑色素瘤皮肤癌的大小。
由于非黑色素瘤皮肤癌的术前大小和解剖位置与Mohs显微手术(MMS)的复杂性相关,患者经常被要求自我报告其术前肿瘤大小,以帮助有效的调度和分诊。我们的目的是通过比较患者对病变大小的估计和Mohs外科医生的测量,来评估患者在MMS之前自我报告的病变测量的准确性。我们对1000名接受MMS治疗并在术前远程医疗访问时自我报告病变大小的患者进行了回顾性图表回顾。患者以一维(1D)/二维(2D)报告其病变大小,或使用铅笔橡皮作为尺寸参考。患者报告二维病变大小的信度极好(类内相关系数[ICC]: 0.916),报告一维病变大小的信度中等(ICC: 0.644)。在使用铅笔橡皮作为尺寸参考时,患者与外科医生的术前测量结果略有一致(κ = 0.178)。必须鼓励皮肤科实践利用远程医疗从使用1D或2D尺寸测量的患者获得手术前尺寸估计。通过使用术前大小估计,外科医生可以更好地对患者进行分诊和安排,为患者及其护理人员提供适当的预期指导。
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