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Anais Brasileiros de Dermatologia
On-line version ISSN 1806-4841
KOPKE, Luis Fernando Figueiredo; GOUVEA, Patricia Salomé and BASTOS, Jose Caldeira Ferreira. A ten-year experience with the Munich method of micrographic surgery: a report of 93 operated cases. An. Bras. Dermatol. [online]. 2005, vol.80, n.6, pp. 583-590. ISSN 1806-4841. http://dx.doi.org/10.1590/S0365-05962005000700003.
BACKGROUND: Mohs surgery is one of the most effective treatments for basal cell carcinomas. The expansion of its concepts enabled developing other equally effective methods to check surgical margins, and the Munich method is an example. OBJECTIVES: To evaluate the effectiveness of the Munich method of micrographic surgery in a ten-year cohort study. METHODS: Ninety-three patients with a total of 96 skin tumors were treated with the Munich method of micrographic surgery, taking part in a follow-up protocol, from May 1994 through July 2004. RESULTS: Of all tumors, 61.4% were recurrent, 42.3% were recurrent more than once, and 53% were of the sclerodermiform type. The mean larger diameter was 1.58cm, and the mean smaller diameter was 1.10cm. In 95% of the cases, total extirpation of the tumor was obtained in three stages. The most common site was nasal (46.3%), followed by periocular (18.9%) and frontal (11.5%). Two patients were lost in follow-up. Of the 96 operated tumors, only 11 had a follow-up time shorter than 2 years. Fifty-six patients were followed for at least 5 years, and 45 (47.3%) for over 6 years. A single relapse was observed, which took place in the sixth year of observation. CONCLUSION: The Munich method is an efficient method of micrographic surgery, as good as the Mohs method. This study provides further evidence that the concept of micrographic surgery must be broadened to surgical excision with microscopic margin control, rather than linking it exclusively to the term "Mohs micrographic surgery".
Keywords : Surgery; Mohs surgery; Skin neoplasms; Reoperation.