Risk Factors and Rate of Recurrence after Mohs Surgery in Basal Cell and Squamous Cell Carcinomas: A Nationwide Prospective Cohort (REGESMOHS, Spanish Registry of Mohs Surgery)


  • Alejandra Tomás-Velázquez Department of Dermatology, University Clinic of Navarra / Fundación Piel Sana, ES-28008 Madrid, Spain
  • Onofre Sanmartin-Jiménez
  • Joan R. Garcés
  • Manuel A. Rodríguez-Prieto
  • Verónica Ruiz-Salas
  • Esther de Eusebio-Murillo
  • Román Miñano-Medrano
  • Begoña Escutia-Muñoz
  • Ángeles Flórez-Menéndez
  • Juan L. Artola-Igarza
  • Alberto Alfaro-Rubio
  • Pilar Gil
  • Yolanda Delgado-Jiménez
  • Julia M. Sanchez-Schmidt
  • Irati Allende-Markixana
  • María L. Alonso-Pacheco
  • Beatriz García-Bracamonte
  • Pablo de la Cueva-Dobao
  • Raquel Navarro-Tejedor
  • Cristina Ciudad-Blanco
  • Lucía Carnero-González
  • Hugo Vázquez-Veiga
  • Natividad Cano-Martínez
  • Eva Vilarrasa-Rull
  • Pedro Sanchez-Sambucety
  • José L. López-Estebaranz
  • Rafael Botella-Estrada
  • Beatriz Gonzalez-Sixto
  • Antonio Martorell-Calatayud
  • Victoriano Morales-Gordillo
  • Agustí Toll-Abelló
  • Izascun Ocerin-Guerra
  • Matías Mayor-Arenal
  • Ricardo Suárez-Fernández
  • Laura Sainz-Gaspar
  • Miguel A. Descalzo
  • Ignacio García-Doval
  • Pedro Redondo




basal cell carcinoma, squamous cell carcinoma, Mohs surgery, recurrence, risk factors


Randomized studies to assess the efficacy of Mohs micrographic surgery in basal cell and squamous cell carcinomas are limited by methodological and ethical issues and a lack of long follow-up periods. This study presents the “real-life” results of a nationwide 7-years cohort on basal cell carcinoma and squamous cell carcinoma treated with Mohs micrographic surgery. A prospective cohort was conducted in 22 Spanish centres (from July 2013 to February 2020) and a multivariate analysis, including characteristics of patients, tumours, surgeries and follow-up, was performed. A total of 4,402 patients followed up for 12,111 patient-years for basal cell carcinoma, and 371 patients with 915 patient-years of follow-up for squamous cell carcinoma were recruited. Risk factors for recurrence included age, non-primary tumours and more stages or unfinished surgeries for both tumours, and immunosuppression for squamous cell carcinoma. Incidence rates of recurrence were 1.3 per 100 person-years for basal cell carcinoma (95% confidence interval 1.1–1.5) and 4.5 for squamous cell carcinoma (95% confidence interval 3.3–6.1), being constant over time (0–5 years). In conclusion, follow-up strategies should be equally intense for at least the first 5 years, with special attention paid to squamous cell carcinoma (especially in immunosuppressed patients), elderly patients, non-primary tumours, and those procedures requiring more stages, or unfinished surgeries.


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How to Cite

Tomás-Velázquez, A., Sanmartin-Jiménez, O., Garcés, J. R., Rodríguez-Prieto, M. A., Ruiz-Salas, V., de Eusebio-Murillo, E., Miñano-Medrano, R., Escutia-Muñoz, B., Flórez-Menéndez, Ángeles, Artola-Igarza, J. L., Alfaro-Rubio, A., Gil, P., Delgado-Jiménez, Y., Sanchez-Schmidt, J. M., Allende-Markixana, I., Alonso-Pacheco, M. L., García-Bracamonte, B., de la Cueva-Dobao, P., Navarro-Tejedor, R., Ciudad-Blanco, C., Carnero-González, L., Vázquez-Veiga, H., Cano-Martínez, N., Vilarrasa-Rull, E., Sanchez-Sambucety, P., López-Estebaranz, J. L., Botella-Estrada, R., Gonzalez-Sixto, B., Martorell-Calatayud, A., Morales-Gordillo, V., Toll-Abelló, A., Ocerin-Guerra, I., Mayor-Arenal, M., Suárez-Fernández, R., Sainz-Gaspar, L., Descalzo, M. A., García-Doval, I., & Redondo, P. (2021). Risk Factors and Rate of Recurrence after Mohs Surgery in Basal Cell and Squamous Cell Carcinomas: A Nationwide Prospective Cohort (REGESMOHS, Spanish Registry of Mohs Surgery). Acta Dermato-Venereologica, 101(11), adv00602. https://doi.org/10.2340/actadv.v101.544