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Related Experiment Videos

Recurrent basal cell carcinoma after incomplete resection.

J K Robinson1, S G Fisher

  • 1Division of Dermatology, Cardinal Bernardin Cancer Center, Loyola University Stritch School of Medicine, 2160 S First Ave, Room 341, Maywood, IL 60153, USA.

Archives of Dermatology
|November 14, 2000
PubMed
Summary

Recurrent basal cell carcinoma (BCC) is challenging to manage. Prompt treatment of positive margins after initial surgery may reduce the extent of subsequent Mohs micrographic surgery (MMS) for BCC.

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Area of Science:

  • Dermatology
  • Surgical Oncology

Background:

  • Historically, a high recurrence rate (30-50%) for basal cell carcinoma (BCC) led to a surgical tradition of not performing additional resection for positive margins.
  • This practice is being re-evaluated due to the complexities of managing recurrent BCC.

Purpose of the Study:

  • To investigate associations between patient/tumor characteristics and recurrence.
  • To determine factors influencing the interval to Mohs micrographic surgery (MMS) and the extent of MMS resection after incomplete BCC excision.

Main Methods:

  • A prospective cohort study accrued 994 patients with incompletely excised head BCCs referred for MMS over 20 years.
  • Data collected included patient demographics, tumor location and histology, reconstructive procedures, interval to recurrence, interval to MMS, and MMS resection extent (surface area, depth, tumor nests).

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Main Results:

  • Longer intervals to recurrence and MMS were observed in men, patients over 65, those with nasal/cheek tumors, aggressive/fibrosing BCC, and those undergoing flap reconstruction (P=.001).
  • MMS resection extent and the number of tumor nests were greater for flap and split-thickness skin graft repairs (P=.001).

Conclusions:

  • Recurrent BCC is more difficult to control.
  • Addressing residual tumor at resection margins promptly could lead to less extensive subsequent surgery, potentially improving outcomes for BCC patients.