Mohs micrographic surgery for male genital tumors: Local recurrence rates and patient-reported outcomes

J Am Acad Dermatol. 2021 Apr;84(4):1030-1036. doi: 10.1016/j.jaad.2020.11.060. Epub 2020 Dec 3.

Abstract

Background: Local recurrence rates (LRRs) after Mohs micrographic surgery (MMS) for male genital cancers have been reported in only a few small case series, and patient-reported outcomes (PROs) have not been studied.

Objective: To determine the LRR and PROs after MMS for male genital skin cancers.

Methods: Retrospective review of all male genital skin cancers removed with MMS between 2008 and 2019 at an academic center. LRR was determined by chart review and phone calls. PROs were assessed by survey.

Results: A total of 119 skin cancers in 108 patients were removed with MMS. Tumors were located on the penis (90/119) and scrotum (29/119). Diagnoses included squamous cell carcinoma in situ (n = 71), invasive squamous cell carcinoma (n = 32), extramammary Paget disease (n = 13), melanoma (n = 2), and basal cell carcinoma (n = 1). The LRR was 0.84% (1/119), with a mean follow-up time of 3.25 years (median, 2.36 years). The majority of survey respondents reported no changes in urinary (66%) or sexual functioning (57.5%) after surgery.

Limitations: Retrospective single-center experience; short follow-up time; low survey response rate; no baseline functional data.

Conclusion: MMS for male genital skin cancer has a low LRR and high patient-reported satisfaction with urinary and sexual function.

Keywords: AJCC staging; Mohs micrographic surgery; NCCN guidelines; local recurrence; male genital cancer; patient-reported outcomes; penile cancer; recurrence rates; scrotal cancer; urinary and sexual functioning.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma in Situ / surgery
  • Carcinoma, Squamous Cell / surgery
  • Genital Neoplasms, Male / epidemiology
  • Genital Neoplasms, Male / surgery*
  • Humans
  • Male
  • Melanoma / surgery
  • Middle Aged
  • Mohs Surgery*
  • Neoplasm Recurrence, Local / epidemiology
  • Paget Disease, Extramammary / surgery
  • Patient Reported Outcome Measures*
  • Patient Satisfaction
  • Penile Neoplasms / epidemiology
  • Penile Neoplasms / surgery
  • Pennsylvania / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Scrotum / surgery
  • Sexual Dysfunction, Physiological / etiology
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / surgery*
  • Urination Disorders / etiology