Citations 1
Interrater and Intrarater Reliability of Mohs Surgeons in the Assessment of MART-1 Frozen Section Margins for Melanoma
Freeman, S. Caleb , Shahwan, Kathryn T. , Aasi, Sumaira Z. , Brewer, Jerry D., Brodland, David G., Christensen, Sean R. , Demer, Addison M. , Holmes, Todd, Nijhawan, Rajiv I. , Saylor, Drew K. , Sobanko, Joseph F. , Zitelli, John A. , Lucero, Olivia M. , Bar, Anna, Carr, David R. , Leitenberger, Justin J. , Miller, Christopher J. , Bordeaux, Jeremy S. , Etzkorn, Jeremy R. , Kibbi, Nour , Maher, Ian A. , Srivastava, Divya , Latour, Emile J. , Yu, Wesley Y. , Carr, David R.
Dermatologic Surgery | October 8, 2025 | Volume: 52 | Issue: 5 | Pages: 421-427
BACKGROUND The use of Mohs micrographic surgery as a treatment for melanoma is rising, but the reliability of Mohs surgeons in assessing MART-1 melanoma en-face margins has not been evaluated. OBJECTIVE To evaluate interrater and intrarater reliability of Mohs surgeons in interpreting margins of early-stage melanoma. METHODS Twenty Mohs surgeons were asked to independently review images of frozen section MART-1 en-face peripheral margins of in situ or early-stage melanoma. Surgeons determined margins as positive or negative at initial evaluation and 6 weeks later. Primary outcomes were interrater and intrarater reliability. RESULTS Interrater agreement was 84.1% (95% confidence interval [CI]: 75.5%–92.8%) for assessment 1 and 87.5% (95% CI: 78.4%–96.4%) for assessment 2, with kappa values 0.68 (95% CI: 0.50–0.82) and 0.75 (95% CI: 0.57–0.88). Average intrarater percent agreement was 95.0% (95% CI: 70.6%–100.0%) with average kappa 0.90 (95% CI: 0.50–1.00). CONCLUSION Substantial interrater and nearly perfect intrarater agreement was identified among surgeons assessing melanoma margins utilizing MART-1 immunostaining, demonstrating consistent and reproducible assessment of melanoma margins during Mohs cases.