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[Facial epitheliomas: general considerations, surgical techniques and indications]
D Martin1, I Barthélémy, J M Mondie
1Service de Chirurgie Plastique Reconstructrice et Esthétique, Centre Hospitalier Universitaire de Bordeaux, Hôpital du Tondu, France.
Annales De Chirurgie Plastique Et Esthetique
|February 2, 1999
Summary
Facial skin cancers, basal cell carcinoma and squamous cell carcinoma, require distinct surgical margins and reconstruction strategies. Management plans address specific anatomical regions and consider recurrence risk for optimal outcomes.
Area of Science:
- Dermatology
- Plastic Surgery
- Oncology
Background:
- Facial skin cancers, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are common in plastic surgery practice.
- Current treatment approaches for these carcinomas often lack standardization, varying between practitioners.
Purpose of the Study:
- To establish a general management plan for facial BCC and SCC.
- To define specific therapeutic strategies based on histological type and anatomical location.
- To outline reconstruction principles and complementary treatments for facial skin cancers.
Main Methods:
- Review of management strategies for BCC and SCC, considering histological duality.
- Definition of differential safety margins for resection: 3-4 mm for BCC, 5-10 mm or more for SCC.
- Selective study of six facial anatomical regions (nasal, orbitopalpebral, labial, malar, frontal, auricular) for reconstruction guidelines.
- Inclusion of frozen section examination for high-risk cases.
- Analysis of a national survey on carcinomas and author's experience.
Main Results:
- Therapeutic strategies are tailored to the histological type of carcinoma, with distinct resection margins.
- Reconstruction approaches vary significantly across different facial sub-regions.
- An incomplete resection index is proposed to predict recurrence.
- Surgery is complemented by other therapeutic modalities and essential surveillance.
Conclusions:
- A structured management plan integrating resection, reconstruction, and surveillance is crucial for facial skin cancers.
- Adherence to specific safety margins and tailored reconstruction based on anatomical location improves outcomes.
- Ongoing surveillance is vital to monitor recurrence and metastatic potential.