比较Mohs显微手术（MMS）和广泛局部切除（WLE） 在罕见非黑素瘤皮肤癌（NMSCs）的生存结果。本研究回顾性分析2003年至2018年间的监测、流行病学和终点数据集（SEER）数据。罕见NMSCs包括默克尔细胞癌、皮肤附属肿瘤、纤维瘤恶性肿瘤和其他罕见NMSCs。采用稳定的倒数概率加权（SIPTW）和Kaplan-Meier方法评估总生存（OS）和癌症特异性生存（CSS）。此外，应用Cox比例风险、Fine-and-Gray回归分析和亚组分析模型来检验基于全因和特定癌症死亡率的MMS与WLE的效应。我们鉴定了6582名罕见NMSCs患者进行生存分析，其中1946名患者（29.5％）接受了MMS，4636名患者（70.5％）接受了WLE。最近一年确诊的疾病、年龄较大、白种人种族、已婚状态、眼睑/面部部位、小肿瘤大小和局部病情是与MMS治疗显著相关的因素。与WLE组相比，MMS组在SIPTW分析前后的OS相当。此外，在调整了其他混杂协变量后，手术类型（WLE vs. MMS）与全因死亡率（风险比[HR]：1.03, 95%置信区间[CI]: 0.94-1.14, P = 0.517） 和疾病特定死亡率（HR:1.16, 95% CI: 0.95-1.42, P = 0.134）无显著关联。此外，亚组分析进一步验证了这些发现。MMS和WLE在罕见NMSCs中具有相当的OS和CSS。S. Karger AG, Basel.

To compare the survival outcomes of Mohs micrographic surgery (MMS) and wide local excision (WLE) for less common nonmelanoma skin cancers (NMSCs).This study retrospectively analyzed data from the Surveillance, Epidemiology, and End Results dataset between 2003 and 2018. The less common NMSCs include Merkel cell carcinoma, skin appendage neoplasm, fibromatous malignancy, and other rare NMSCs. The stabilized inverse probability of treatment weighting (SIPTW) and the Kaplan-Meier methods were adopted to assess the overall survival (OS) and cancer-specific survival (CSS). Furthermore, the Cox proportional hazards, Fine-and-Gray regression analysis, and subgroup analysis models were applied to examine the effects of MMS vs. WLE based on all-cause and cancer-specific mortality.We identified 6582 individuals with less common NMSCs for survival analysis, among which 1946 patients (29.5%) had undergone MMS and 4636 (70.5%) had received WLE. Diseases diagnosed in the most recent year, older age, the White race, married status, eyelid/face site, small tumor size, and localized disease were factors significantly associated with MMS treatment. Compared with the WLE group, the MMS group had comparable OS before and after the SIPTW analysis. Additionally, after adjusting for other confounding covariates, the surgery type (WLE vs. MMS) did not show significant associations with all-cause mortality (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 0.94-1.14, P = 0.517) and disease-specific mortality (HR: 1.16, 95% CI: 0.95-1.42, P = 0.134). Moreover, the subgroup analysis validated these findings.MMS and WLE have comparable OS and CSS for less common NMSCs.S. Karger AG, Basel.