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Incompletely excised basal cell carcinoma: a management dilemma?
1Department of Plastic and Reconstructive Surgery, Middlemore Hospital, Auckland, New Zealand.
Summary
Observation is a suitable approach for most incompletely excised basal cell cancers (BCC). Most recurrences of BCC appear early, necessitating close patient follow-up for at least three years.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Incompletely excised basal cell cancers (BCC) have high recurrence rates (30-67%).
- Recurrent BCC can be destructive.
- Surgeons face a dilemma regarding immediate re-excision versus observation for incompletely excised BCC.
Purpose of the Study:
- To identify clinical or morphological features predicting recurrence in incompletely excised BCC.
- To aid in the management decisions for incompletely excised BCC.
Main Methods:
- Retrospective review of Middlemore Hospital histology records from 1986.
- Analysis of management and recurrence rates for 82 incompletely excised BCCs.
- Correlation of clinical and morphological features with recurrence rates.
Main Results:
- Overall recurrence rate was 30.0% with a median time to recurrence of 18.5 months.
- No significant impact on recurrence rates was found based on margin status, tumor site, histology, patient sex, or prior treatment.
- The margin of incomplete resection did not influence recurrence rates.
Conclusions:
- Observation is a viable management strategy for most incompletely excised BCCs.
- Only one-third of cases required further treatment.
- Early recurrence is common, highlighting the need for diligent follow-up for at least three years.