Mohs surgery for lip basal and squamous cell carcinomas: A systematic review and meta-analysis of patient profiles and outcomes

Cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) develop on mucosal and cutaneous surfaces of the lip, leading to increased morbidity due to the delicate nature of this area. This study characterizes trends in lip SCC and BCC treated with Mohs micrographic surgery. A systematic review of PubMed, EMBASE, Cochrane, and Web of Science from inception through November 2023 was performed. Included studies discussed Mohs micrographic surgery outcomes for lip SCC and BCC. SCC was predominantly found on the lower lip (72.1%; 95% CI, 44.1% to 100%), while BCC occurred mostly on the upper lip (91.3%; 95% CI, 84.5% to 98.0%). Mucosal lip SCCs were 27.15 times more frequent than cutaneous lip SCCs (odds ratio: 27.2; 95% CI, 4.81-153.3); 95.6% of lower lip SCCs were mucosal. Most lip SCCs (66.2%) and BCCs (93.7%) were <2 centimeters. SCCs were most commonly well-differentiated (55.8%; 95% CI, 40.9% to 70.6%) while BCCs were most commonly nodular (43.6%; 95% CI, 20.9% to 66.2%). Recurrence rates were 2.1% (95% CI, 1.4% to 2.9%) for SCC and 0.5% (95% CI, 0% to 1.1%) for BCC. SCCs predominantly affect the lower mucosal lip of males while BCCs largely affect the upper cutaneous lip of females. Mohs micrographic surgery is highly effective for treating SCC and BCC of the lip.