Rigel et al developed a Recurrence Index Score for predicting the risk of recurrent basal cell carcinoma following a Mohs excision. This can help identify patients who may require closer monitoring during followup. The authors are from the New York University Medical Center.
Parameters:
(1) gender
(2) age
(3) diameter of lesion prior to excision
(4) surgical stages done during the Mohs procedure
(5) history of previous therapy
(6) number of previous curettage-electrodesiccation treatments
(7) number of previous surgical excisions
(8) anatomic site
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
15 |
|
age |
<= 49 |
22 |
|
|
>= 50 |
0 |
|
diameter of the lesion |
< 1.0 cm |
10 |
|
|
1.0 - 1.9 cm |
16 |
|
|
2.0 - 2.9 cm |
19 |
|
|
3.0 - 3.9 cm |
21 |
|
|
4.0 - 4.9 cm |
50 |
|
|
>= 5.0 cm |
56 |
|
surgical stages performed |
1 - 6 |
0 |
|
|
>= 7 |
44 |
|
history of previous therapy |
none |
0 |
|
|
any kind |
12 |
|
number of previous curettage-electrodesiccation treatments |
0, 1 or 2 |
0 |
|
|
>= 3 |
18 |
|
number of previous conventional surgical excisions |
0 or 1 |
0 |
|
|
>= 2 |
24 |
|
anatomic site |
retroauricular region |
134 |
|
|
ear |
43 |
|
|
chin |
43 |
|
|
periorbital region |
40 |
|
|
scalp |
37 |
|
|
trunk |
30 |
|
|
nose |
30 |
|
|
cheek |
24 |
|
|
forehead |
19 |
|
|
perioral region |
19 |
|
|
neck |
1 |
|
|
extremities |
0 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 10
• maximum score: 325
• The higher the score the greater the risk for a recurrence.
|
Total Score |
Risk of Recurrence |
Probability of Recurrence |
|
10 - 34 |
none |
0% |
|
35 - 54 |
low |
0.7% |
|
55 - 99 |
average |
2.6% |
|
>= 100 |
high |
10% |
Limitations:
• Some apparent recurrences may be due to emergence of another primary in an area of sun-damaged skin.
Specialty: Hematology Oncology, Surgery, general, Dermatology
