Cheraghlou S, et al. - In this retrospective cohort study, researchers used the National Cancer Database to assess overall survival of patients undergoing excision of stage I melanoma (defined by the American Joint Committee on Cancer Cancer Staging Manual, 8th edition) with Mohs micrographic surgery (MMS) vs patients receiving traditional wide margin excision (WME). In total, 70,319 eligible individuals (median [SD] age, 57.0 [16.2] years) were identified, including 67,085 treated with WME and 3234 treated with MMS. Multivariable Cox proportional hazards regression survival analysis controlling for clinical and tumor factors showed that treatment with MMS was related to a modest improvement in overall survival relative to WME (hazard ratio, 0.86). Such findings suggest that Mohs micrographic surgery can provide an alternative to WME in properly selected early-stage invasive melanoma cases without sacrificing patient survival.