A single-center retrospective study on 3,957 consecutive excisions of basal cell carcinomas. BCC behavior patterns: retrospective statistical analysis

Abstract

Basal cell carcinoma (BCC) is the most common skin malignancy. BCC generally has a clinical course characterized by slow growth, minimal local invasiveness, and a high cure rate. Occasionally, however, BCC behaves aggressively with deep tissue invasion, clinical recurrence, and regional/distant metastases. Surgical excision is uniformly indicated as a primary treatment. We carried out a retrospective study by selecting all patients operated for BCC in our Plastic Surgery Department between 1 January 1992 and 1 September 2007. The data collected were about 3,957 excisions performed on 2,358 individuals which is, to our knowledge, the largest population sample ever studied internationally. For this reason, we analyzed the most common BCC features generally reported in published papers so as to identify any difference compared to the data that we gathered in our series. From all of the collected data of the 2,358 patients and 3,957 excisions, 16 variables were drawn, which provided detailed information about patients' status, biopsy when performed, surgery, and follow-up. All results concerning such variables are discussed. The results of our retrospective statistical analysis on a very large, single-center patient population sample are fully in line with what were previously published in the international literature.

Matter of margins

“…18,19 The first important data obtained in our analysis were the percentage of involved margins (PIM); 4.97% is significantly lower than percentages reported from case studies, similar in number but gathered by other specialists and where the incomplete excision was from 6.3% to 13.9%. 11,21 Our data were close to those reported in dermatological case studies despite being performed on small series. 12,22 The observation of skin lesions and knowledge of the clinical and biological characteristics of skin cancers certainly play a crucial role in the ability to define margins.…”

“…The first important data obtained in our analysis were the percentage of involved margins (PIM); 4.97% is significantly lower than percentages reported from case studies, similar in number but gathered by other specialists and where the incomplete excision was from 6.3% to 13.9% . Our data were close to those reported in dermatological case studies despite being performed on small series …”