Assessment of incompletely excised basal cell carcinomas in six facial areas: influence of elastosis

Incomplete excision of non-melanoma skin cancer is a clinical indicator of surgical care. With most basal cell carcinomas arising on the face and considering the cosmetic and functional structures involved, it is interesting to identify what are the areas within the face with more likelihood of incomplete excision and the factors implicated. The aim of this study was to identify those areas and possible predictive factors. Six anatomical regions were considered and studied selectively.

A monocentric study was performed reviewing all facial basal cell carcinomas excised at our center during 2010. Data were analyzed using SPSS software.

202 lesions from 202 subjects were studied. The percentage of incomplete excision was 17.07%.

Lesions located in the orbitopalpebral and auricular areas and those with moderate to severe grade of associated elastosis are more likely to be incompletely excised. Wider surgical margins are observed in frontal, malar and labial areas which are distant from functional structures. The following tumor features were found to be a risk factor for incomplete resection: morpheic or superficial histology, large lesions (>20 mm) and thick lesions (>6 mm).