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On the different methods of micrographic surgery and their differences in the visualization of the tumor and surgical margin, and in the contribution to clinical and oncological aspects
Sandro Simão Corrêa Filho
Private Clinic, Blumenau, SC, Brazil
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class="elsevierStyleTextfn">Correspondence</span>" "titulo" => "On variations in micrographic surgery and the use of horizontal histological sections in the evaluation of the surgical margin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "545" "paginaFinal" => "546" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Anna Carolina Miola, Hélio Amante Miot, Luis Fernando Figueiredo Kopke" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Anna Carolina" "apellidos" => "Miola" ] 1 => array:2 [ "nombre" => "Hélio Amante" "apellidos" => "Miot" ] 2 => array:2 [ "nombre" => "Luis Fernando Figueiredo" "apellidos" => "Kopke" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220302101" "doi" => "10.1016/j.abdp.2020.02.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302101?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620301409?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000004/v3_202008041755/S0365059620301409/v3_202008041755/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Correspondence</span>" "titulo" => "On the different methods of micrographic surgery and their differences in the visualization of the tumor and surgical margin, and in the contribution to clinical and oncological aspects" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "546" "paginaFinal" => "547" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Sandro Simão Corrêa Filho" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Sandro" "apellidos" => "Simão Corrêa Filho" "email" => array:1 [ 0 => "sscorrea@gmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Private Clinic, Blumenau, SC, Brazil" "identificador" => "aff0005" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Micrographic surgery was developed in the 1930s by Dr. Friedrich Mohs, using the <span class="elsevierStyleItalic">in vivo</span> tissue fixation method. In 1970, Stegman and Tromovitch published a series of cases using <span class="elsevierStyleItalic">ex vivo</span> fixation. In 1995, the Munich method was described.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Since then, surgeons have been constantly learning these techniques.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1–4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In the study by Portela et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> a new form of debulking assessment was described, but it is identical to the Munich method previously described in the literature. The concepts of margin and surgical border are imprecise. The authors illustrate an essential feature of the Munich method: the possibility of assessing the tumor–surgical margin relationship and observation of the tumor. Thus, it is possible to better demonstrate the subtype, cytological aspects, and tumor architecture, which have clinical and oncological relevance and are important for decision making. These factors gain importance in tumors with rarer histology and with greater metastatic potential; it also facilitates the identification of perineural invasion. In turn, peripheral methods evaluate only the surgical border, and do not observe the tumoral core. Although bread-loafing of the paraffin block is performed during debulking, the sample is smaller and the results are not available in the trans-operative period, given the time required for paraffin embedding and processing. A drawback of the fresh method is the greater chance of technical artifacts (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The author of this correspondence highlights the importance of broadening the discussion of the technical and laboratory details of the various forms of micrographic surgery, including the implications of each technique for the clinical and oncological data.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0030" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Author's contributions</span><p id="par0035" class="elsevierStylePara elsevierViewall">Sandro Simão Corrêa Filho: Approval of the final version of the manuscript; conception and planning of the study; drafting and editing of the manuscript; critical review of the literature; critical review of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Author's contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-02-25" "fechaAceptado" => "2020-03-02" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">How to cite this article: Corrêa Filho SS. On the different methods of micrographic surgery and their differences in the visualization of the tumor and surgical margin, and in the contribution to clinical and oncological aspects. An Bras Dermatol. 2020;95:546–7.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Study conducted at the Private Clinic, Blumenau, SC, Brazil.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Munich method \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Peripheral methods (Mohs, Tübingen, muffin) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observation of the tumor core \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tumor analysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No (only if there is tumor involvement of the surgical border) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Evaluation of the cutaneous tumor site<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observation of the tumor-surgical margin relationship \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Analysis of tumor cytology (<span class="elsevierStyleItalic">e.g</span>., mitotic figures) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No (only if there is tumor involvement of the surgical border) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Assessment of perineural involvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Easier \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">More difficult \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of glass slides \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Greater \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Smaller \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2352777.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Even if a previous biopsy of the affected area is performed, there may be a discrepancy between the data from the incisional biopsy and the posterior excision due to sampling, as pointed out by Portela et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Important in ill-defined tumors or scars.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparison between some characteristics of the Munich method and peripheral methods<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A ten-year experience with the Munich method of micrographic surgery: a report of 93 operated cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.F.F. Kopke" 1 => "P.S. Gouvea" 2 => "J.C.F. Bastos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2005" "volumen" => "80" "paginaInicial" => "583" "paginaFinal" => "590" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mohs micrographic surgery: current techniques" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O. Arnon" 1 => "R.P. Rapini" 2 => "A.J. Mamelak" 3 => "L.H. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 14 | 10 | 24 |
| 2024 October | 91 | 58 | 149 |
| 2024 September | 114 | 77 | 191 |
| 2024 August | 117 | 102 | 219 |
| 2024 July | 108 | 105 | 213 |
| 2024 June | 82 | 63 | 145 |
| 2024 May | 72 | 58 | 130 |
| 2024 April | 82 | 83 | 165 |
| 2024 March | 70 | 66 | 136 |
| 2024 February | 83 | 73 | 156 |
| 2024 January | 79 | 54 | 133 |
| 2023 December | 62 | 61 | 123 |
| 2023 November | 66 | 68 | 134 |
| 2023 October | 46 | 71 | 117 |
| 2023 September | 59 | 70 | 129 |
| 2023 August | 52 | 32 | 84 |
| 2023 July | 43 | 30 | 73 |
| 2023 June | 52 | 28 | 80 |
| 2023 May | 37 | 18 | 55 |
| 2023 April | 27 | 14 | 41 |
| 2023 March | 47 | 50 | 97 |
| 2023 February | 37 | 29 | 66 |
| 2023 January | 32 | 34 | 66 |
| 2022 December | 30 | 20 | 50 |
| 2022 November | 55 | 49 | 104 |
| 2022 October | 52 | 52 | 104 |
| 2022 September | 38 | 57 | 95 |
| 2022 August | 33 | 39 | 72 |
| 2022 July | 33 | 49 | 82 |
| 2022 June | 35 | 50 | 85 |
| 2022 May | 31 | 53 | 84 |
| 2022 April | 29 | 54 | 83 |
| 2022 March | 33 | 64 | 97 |
| 2022 February | 22 | 39 | 61 |
| 2022 January | 43 | 77 | 120 |
| 2021 December | 39 | 69 | 108 |
| 2021 November | 33 | 60 | 93 |
| 2021 October | 50 | 75 | 125 |
| 2021 September | 27 | 48 | 75 |
| 2021 August | 31 | 47 | 78 |
| 2021 July | 34 | 46 | 80 |
| 2021 June | 30 | 46 | 76 |
| 2021 May | 30 | 62 | 92 |
| 2021 April | 137 | 216 | 353 |
| 2021 March | 42 | 46 | 88 |
| 2021 February | 12 | 20 | 32 |
| 2021 January | 18 | 16 | 34 |
| 2020 December | 17 | 29 | 46 |
| 2020 November | 11 | 12 | 23 |
| 2020 October | 11 | 9 | 20 |
| 2020 September | 12 | 13 | 25 |
| 2020 August | 15 | 12 | 27 |
| 2020 July | 39 | 15 | 54 |
| 2020 June | 12 | 13 | 25 |
| 2020 May | 8 | 16 | 24 |
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