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Surgical management of incompletely excised basal cell carcinomas of the head and neck

2004; Elsevier BV; Volume: 42; Issue: 4 Linguagem: Inglês

10.1016/j.bjoms.2004.02.030

1532-1940

A. Wilson, Geoffrey Howsam, Vijay Santhanam, David MacPherson, Jerry Grant, C.A. Pratt, John Townend,

Head and Neck Cancer Studies

We made a retrospective audit of all basal cell carcinomas excised in the Maxillofacial Units at St. Richard's Hospital, Chichester and the Worthing and Southlands NHS Trust between 1990 and 1999. A total of 3795 BCCs were excised. Of these, 3560 were completely excised (93.8%) and 235 were incompletely excised (6.2%), which compares favourably with other series. Of these, 84 patients had further excision, 11 had radiotherapy, and 140 were kept under review. Residual tumour was present in 45% of the re-excised specimens. Of the 140 cases managed by observation, 21% recurred. Notably, 31% of patients in the observation cohort died of other causes without recurrence. Incomplete excision was significantly more likely (P < 0.001) if multiple lesions were excised at the time of operation. Involvement of multiple margins was not a significant risk factor for recurrence in the 'observed' cohort. This study shows that a flexible strategy, which balances observation, further excision and radiotherapy, is superior to any single approach.