Incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit

Kumar, Princy; Orton, C.I.; McWilliam, L J; Watson, S.J.

doi:10.1054/bjps.2000.3394

Cited by 90 publications

(127 citation statements)

References 21 publications

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“…Incomplete resections that are difficult to deal with, such as in patients with a definitively closed defect other than those closed directly with tumour at the resection margins in the permanent section analysis was only 5 of 97 cases (5%). This compares favourably with other reports [2,19,20] and confirms that the frequent use of preoperative punch biopsy and frozen section analysis combined with permanent section analysis in selected cases is a successful way of controlling and achieving complete excision. However, as permanent section analysis resulted in a higher rate of incomplete excisions, we recommend that they should be combined with frozen section analysis.…”

Section: Discussionsupporting

confidence: 86%

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Morphoeic basal cell carcinoma of the face

Erba

Farhadi

Wettstein

et al. 2007

Scandinavian Journal of Plastic and Reconstructive Surgery and

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The morphoeic (or sclerosing) basal cell carcinoma (mBCC) is the most aggressive subtype, as it spreads into the dermis beyond the clinically visible or palpable borders, making complete excision difficult. Our aim was to identify variables in the surgical management that might increase the rate of complete resection, so we made a retrospective study of 97 mBCCs. One-stage procedures (frozen section analysis) had a higher rate of complete resection (63 of 69, 91%) than two-stage procedures (permanent section analysis) (19 of 28, 68%, p<0.05). The false negative rate of frozen section analysis was 9%. Experienced surgeons had more complete excisions and a lower rate of operative re-excisions. The use of frozen section analysis is an effective way of judging invasion of margins by mBCC. The estimation of tumour margins and the treatment of mBCC requires substantial clinical experience.

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Section: Discussionsupporting

confidence: 86%

“…Most BBC develop in the head and neck region [2], and the three most usual subtypes are morphoeic, nodular, and superficial [3]. Morphoeic BCC are aggressive, and tend to extend into the dermis beyond the level where they are clinically visible or palpable, making complete excision difficult [4].…”

Section: Introductionmentioning

confidence: 99%

Morphoeic basal cell carcinoma of the face

Erba

Farhadi

Wettstein

et al. 2007

Scandinavian Journal of Plastic and Reconstructive Surgery and

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“…Tumors exhibit an aggressive attitude with potential early invasion of the orbit and skull base. A radical excision at these sites usually requires a technically demanding functional reconstruction (15). The refined statistical analysis is likely to eventually suggest the effectiveness of an intraoperative frozen section in obtaining a higher success rate (87.50 vs. 69.77%, odds ratio 2.98) in the surgical treatment of non-melanoma skin cancers of the eyelids (Table IV).…”

Section: Discussionmentioning

confidence: 99%

Study to determine whether intraoperative frozen section biopsy improves surgical treatment of non-melanoma skin cancer

Nicoletti

Brenta

Malovini

et al. 2012

Molecular and Clinical Oncology

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Abstract. Skin cancers are the most common types of cancer and their incidence has shown an increase of ~4 to 8% per year over the last 40 years. The majority of skin cancers (~97%) are non-melanoma skin cancers, mainly represented by basal cell (80%) and squamous cell carcinomas (20%). The use of intra-operative frozen section remains controversial in the surgical treatment of non-melanoma skin cancer, being commonly considered an optional tool, the reliability and effectiveness of which remain questionable. A large retrospective study was conducted to examine 670 surgical excisions of non-melanoma skin cancers of the head and neck in 481 patients over a period of nine years, between May, 2002 and December, 2011, at the Plastic and Reconstructive Surgery Unit of the University of Pavia, Salvatore Maugeri Research and Care Institute, Pavia, Italy. Results demonstrated the paradoxical ineffectiveness of an intra-operative frozen section biopsy in pursuing higher rates of radical excision in non-melanoma skin cancers. Nevertheless, a more detailed analysis on the use of frozen sections focusing on the various anatomical sites of the body demonstrated a reverse trend in the eyelids and canthi, where a higher success rate (87.50 vs. 69.77%) in the surgical treatment of non-melanoma skin cancers was obtained with the use of an intra-operative frozen section biopsy. Results of the present study suggested that intra-operative frozen section biopsy be routinely used in the surgical treatment of nonmelanoma skin tumors involving the eyelids and canthi.

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“…The incidence of incomplete excision of BCC has varied, with reports ranging from 4.7% to 10.8% of treated patients (68,69). The success of surgical excision can vary depending on the experience of the surgeon, histologic subtype, and excision margin (70). In a retrospective cohort analysis of 1983 BCC cases, significant risk factors for incomplete excision included lesions located on the head and neck ( P < 0.001), surgeons performing < 51 procedures during the 2-year study period ( P < 0.001), and patients with aggressive histologic BCC subtypes (e.g.…”

Section: Surgerymentioning

confidence: 99%

An Overview on Basal Cell Carcinoma

Avcı¹

2011

Skin Cancer Overview

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Incidence of incomplete excision in surgically treated basal cell carcinoma: a retrospective clinical audit

Cited by 90 publications

References 21 publications

Morphoeic basal cell carcinoma of the face

Morphoeic basal cell carcinoma of the face

Study to determine whether intraoperative frozen section biopsy improves surgical treatment of non-melanoma skin cancer

An Overview on Basal Cell Carcinoma

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