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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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| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 15 | 10 | 25 |
| 2024 Outubro | 91 | 58 | 149 |
| 2024 Setembro | 114 | 77 | 191 |
| 2024 Agosto | 117 | 102 | 219 |
| 2024 Julho | 108 | 105 | 213 |
| 2024 Junho | 82 | 63 | 145 |
| 2024 Maio | 72 | 58 | 130 |
| 2024 Abril | 82 | 83 | 165 |
| 2024 Março | 70 | 66 | 136 |
| 2024 Fevereiro | 83 | 73 | 156 |
| 2024 Janeiro | 79 | 54 | 133 |
| 2023 Dezembro | 62 | 61 | 123 |
| 2023 Novembro | 66 | 68 | 134 |
| 2023 Outubro | 46 | 71 | 117 |
| 2023 Setembro | 59 | 70 | 129 |
| 2023 Agosto | 52 | 32 | 84 |
| 2023 Julho | 43 | 30 | 73 |
| 2023 Junho | 52 | 28 | 80 |
| 2023 Maio | 37 | 18 | 55 |
| 2023 Abril | 27 | 14 | 41 |
| 2023 Março | 47 | 50 | 97 |
| 2023 Fevereiro | 37 | 29 | 66 |
| 2023 Janeiro | 32 | 34 | 66 |
| 2022 Dezembro | 30 | 20 | 50 |
| 2022 Novembro | 55 | 49 | 104 |
| 2022 Outubro | 52 | 52 | 104 |
| 2022 Setembro | 38 | 57 | 95 |
| 2022 Agosto | 33 | 39 | 72 |
| 2022 Julho | 33 | 49 | 82 |
| 2022 Junho | 35 | 50 | 85 |
| 2022 Maio | 31 | 53 | 84 |
| 2022 Abril | 29 | 54 | 83 |
| 2022 Março | 33 | 64 | 97 |
| 2022 Fevereiro | 22 | 39 | 61 |
| 2022 Janeiro | 43 | 77 | 120 |
| 2021 Dezembro | 39 | 69 | 108 |
| 2021 Novembro | 33 | 60 | 93 |
| 2021 Outubro | 50 | 75 | 125 |
| 2021 Setembro | 27 | 48 | 75 |
| 2021 Agosto | 31 | 47 | 78 |
| 2021 Julho | 34 | 46 | 80 |
| 2021 Junho | 30 | 46 | 76 |
| 2021 Maio | 30 | 62 | 92 |
| 2021 Abril | 137 | 216 | 353 |
| 2021 Março | 42 | 46 | 88 |
| 2021 Fevereiro | 12 | 20 | 32 |
| 2021 Janeiro | 18 | 16 | 34 |
| 2020 Dezembro | 17 | 29 | 46 |
| 2020 Novembro | 11 | 12 | 23 |
| 2020 Outubro | 11 | 9 | 20 |
| 2020 Setembro | 12 | 13 | 25 |
| 2020 Agosto | 15 | 12 | 27 |
| 2020 Julho | 39 | 15 | 54 |
| 2020 Junho | 12 | 13 | 25 |
| 2020 Maio | 8 | 16 | 24 |
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