没有随机对照试验可指导使用传统切除（CE）治疗头颈部侵袭性黑色素瘤的手术边缘。莫氏显微手术（MMS）已证明对头颈部侵袭性黑色素瘤的局部复发率和生存率有所提高。确定使用MMS治疗头颈部侵袭性黑色素瘤的当地、淋巴结和远处复发率（LR、NR、DR，分别为 Local Recurrence、Nodal Recurrence 和 Distant Recurrence）以及疾病特异性生存率（DSS）。进行了对使用MART-1免疫组化染色的冰冻切片进行MMS治疗的785例头颈部侵袭性黑色素瘤的长期效果进行回顾性多中心研究，持续12年。785例黑色素瘤（厚度为0.3mm-8.5mm）接受了MMS的治疗。LR、NR和DR率分别为0.51%（4/785）、1.0%（8/785）和1.1%（9/785）。对于T1、T2、T3和T4肿瘤，LR分别为0.16%（1/636）、1.18%（1/85）、2.22%（1/45）和5.26%（1/19）。五年和十年DSS分别为96.8%（95%CI 95.0%-98.5%）和93.4%（95%CI 88.5%-98.3%）。这是一项非随机回顾性研究。与历史队列患者使用CE治疗的荟萃分析相比，MMS在局部复发方面取得了显著的改善。MMS应被视为治疗头颈部侵袭性黑色素瘤的重要手术选择。版权所有 © 2023 Elsevier Inc. 发表。

There are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision (CE). Mohs Micrographic Surgery (MMS) has shown improved local recurrence rates and survival for invasive H&N melanomas.Determine local, nodal, and distant recurrence rates (LR, NR, DR respectively), and disease-specific survival (DSS) for invasive melanoma of the head and neck treated with MMS.A retrospective multicenter study of 785 cases of invasive H&N melanoma treated with MMS using frozen sections with MART-1 immunohistochemical staining was performed to evaluate long-term outcomes over 12-years.785 melanomas (thickness 0.3mm-8.5mm) were treated with MMS. LR, NR, and DR rates were 0.51% (4/785), 1.0% (8/785), and 1.1% (9/785) respectively. For T1, T2, T3 and T4 tumors LR was 0.16% (1/636), 1.18% (1/85), 2.22% (1/45), and 5.26% (1/19), respectively. Five and 10-year DSS were 96.8% (95%CI 95.0%-98.5%) and 93.4% (95%CI 88.5%-98.3%).A non-randomized retrospective study.MMS achieves significant improvements in local recurrence compared to a meta-analysis of historical cohorts of patients treated with CE. MMS should be considered an important surgical option for invasive head and neck melanoma.Copyright © 2023. Published by Elsevier Inc.