Basal cell carcinomata-risk factors for incomplete excision and results of re-excision

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2016-05, Vol.69 (5), p.652-656
• Main Authors: Masud, D., FRCS (plast), Moustaki, M, Staruch, R, Dheansa, B., FRCS(Plast)
• Format: Article
• Language: English
• Subjects: Basal cell carcinoma; Carcinoma, Basal Cell - pathology; Carcinoma, Basal Cell - surgery; Humans; Incomplete excision; Margins of Excision; Neoplasm, Residual; Non melanoma; Plastic Surgery; Reoperation - statistics & numerical data; Retrospective Studies; Risk Factors; Skin cancer; Skin Neoplasms - pathology; Skin Neoplasms - surgery
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2015.12.024

Abstract Introduction Re-excising incompletely excised basal cell carcinomas can be unsatisfactory when there is no residual tumour present. Recommended guidelines do suggest re-excision as a treatment modality however its value has been questioned due to low or variable residual tumour presence. We analysed our incomplete excisions and re-excision rates, and residual tumour presence over an 18-month period in a single unit. Method 2586 primary excisions of basal cell carcinomas in 1717 patients were audited using pathology results and case notes. Results There was a 7.1% (184/2586) incomplete excision rate. Excising a lesion in a multiple excision lesion procedure was associated with a higher rate of incomplete excision when comparing to a single lesion excision procedure (61.5% v 38.5%). Of the incompletely excised basal cell carcinomas, 33.6% (62/184) had further re-excision and of these, 62.9% (39/62) had residual tumour present. Although the figures are small, most anatomical sites examined had a greater than 50% residual tumour presence. Conclusion After evaluating each patient individually, due to a high residual tumour rate presence re-excising an incompletely excised basal cell carcinoma still would be a worthwhile procedure.