Evaluation of histopathological margin and other recurrence parameters in basal cell carcinoma: A retrospective analysis of 8821 lesions


YILDIZDAL S., Kucukguven A., ÇALIŞ M., VARGEL İ.

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, cilt.75, sa.9, ss.3390-3397, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 75 Sayı: 9
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.bjps.2022.06.013
  • Dergi Adı: JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.3390-3397
  • Anahtar Kelimeler: Recurrence, Histopathological margin, Re-excision, Deep tissue invasion, Residual tumour, MOHS MICROGRAPHIC SURGERY, INCOMPLETE EXCISION, RISK-FACTORS, MANAGEMENT, RATES
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Basal cell carcinoma (BCC) is the most common skin cancer. Removing the lesion with wide surgical margins and obtaining a microscopically intact margin is considered suffi-cient in the treatment of BCC. However, it may not always be possible to provide wide and intact margins in cosmetically and functionally important areas. Although recurrence rates af-ter BCC excision vary among studies, the recurrence rate at 5 years is considered to be 2%. BCC subtype, perineural invasion, and close margin are important factors in recurrence. The aims of this study are to investigate the other factors associated with recurrence in BCC treatment and reveal the value of the "histopathological surgical margin" which can help in making the decision for re-excision. A statistically significant correlation is observed between the increase in tumour size and recurrence(p< 0.05). The recurrence rate after excision with a histopathologic margin of 1 mm or less is 19%. This rate is found to be 8% in patients with a histopathological margin greater than 1 mm and 3 mm or less. Reticular dermis and deeper tissue invasion statistically increase the recurrence rate. Multiple excision and the presence of residual tumour in the re-excision sample also increase the recurrence rate. In conclusion, recurrence in BCC patients is affected by more than one parameter. We highly recommend re-excision in patients with a histopathological margin of 1 mm or less. In tu-mours with histopathological margins between 1 mm and 3 mm, the decision for re-excision or "wait-and-see" approach should be made according to the characteristics of the tumours and patients. (c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by El-sevier Ltd. All rights reserved.