Narrow‐margin excision is a safe, reliable treatment for well‐defined, primary pigmented basal cell carcinoma: an analysis of 288 lesions in Japan

Ito, Takamichi; Inatomi, Yusuke; Nagae, Konosuke; Nakano-Nakamura, Misa; Nakahara, Takeshi; Furue, Masutaka; Uchi, Hiroshi

doi:10.1111/jdv.12689

Cited by 40 publications

(52 citation statements)

References 15 publications

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“…Exceptions may be made for small, well‐defined nodular BCC (nBCC) and pigmented BCC lesions. Here, complete removal is achieved in almost all cases with narrow surgical margins of 2 to 3 mm . If microscopically controlled surgery is not available, tumors with a high recurrence risk (Table ) should be removed using conventional excision with surgical margins of more than 5 mm.…”

Section: Risk Stratificationmentioning

confidence: 99%

S2k Guidelines for Cutaneous Basal Cell Carcinoma – Part 2: Treatment, Prevention and Follow‐up

Lang

Balermpas

Bauer

et al. 2019

J Deutsche Derma Gesell

125

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SummaryBasal cell carcinoma (BCC) is the most common malignant tumor among fair‐skinned individuals, and its incidence had been steadily rising in the past decades. In order to maintain the highest quality of patient care possible, the German S2k guidelines were updated following a systematic literature search and with the participation of all professional societies and associations involved in the management of the disease. Part 2 addresses issues such as proper risk stratification, the various therapeutic approaches, and prevention as well as follow‐up of patients with basal cell carcinoma.

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Section: Risk Stratificationmentioning

confidence: 99%

S2k Guidelines for Cutaneous Basal Cell Carcinoma – Part 2: Treatment, Prevention and Follow‐up

Lang

Balermpas

Bauer

et al. 2019

J Deutsche Derma Gesell

125

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“…Zur Rezidiv‐Vermeidung sollten bei Tumoren mit niedrigem Rezidivrisiko Sicherheitsabstände von 3 bis 5 mm geplant werden. Ausnahmen können kleinere scharf abgrenzbare noduläre Basalzellkarzinome (nBZK) und pigmentierte BZK darstellen, in denen auch mit knappen Resektionsrändern von 2 bis 3 mm eine vollständige Entfernung in nahezu allen Fällen erreicht werden kann . Bei Tumoren mit hohem Rezidivrisiko (Tabelle ), in denen keine mikroskopisch kontrollierte Chirurgie verfügbar ist, sollte der Sicherheitsabstand bei konventioneller Exzision über 5 mm liegen.…”

Section: Chirurgische Therapieunclassified

“…Neuere Daten von Arits et al. zeigen in einer Vergleichsstudie zwischen MAL‐PDT, Imiquimod und 5‐FU, dass 5‐FU in der Behandlung von sBZK etwa gleich effektiv wie MAL‐PDT, jedoch Imiquimod unterlegen ist (Tumorfreiheit nach 12 Monaten: 72,8 % [95 %‐KI 66,8–79,4] für MAL‐PDT, 83,4 % für Imiquimod, 80,1 % …”

Section: Topische Therapieunclassified

S2k‐Leitlinie Basalzellkarzinom der Haut – Teil 2: Therapie, Prävention und Nachsorge

Lang

Balermpas²,

Bauer

et al. 2019

J Deutsche Derma Gesell

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Zusammenfassung Das Basalzellkarzinom (BZK) ist der häufigste maligne Tumor der hellhäutigen Bevölkerung mit jährlich steigender Inzidenz. Eine Aktualisierung der S2k‐Leitlinie unter Beteiligung aller mit dem Krankheitsbild vertrauten Fachgesellschaften sowie vorangegangener Literaturrecherche ist für die Qualität der Versorgung der betroffenen Patienten von essentieller Bedeutung. Im vorliegenden Teil 2 wird zunächst eine Risikostratifizierung aufgezeigt, bevor die verschiedenen Therapieoptionen diskutiert werden. Zudem werden Prävention und Nachsorge der Erkrankung behandelt.

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“…3 These strategies are based on studies in the Caucasian population on primary and recurrent BCCs that arise as non-pigmented lesions and/or with poorly defined clinical tumour borders. 4 However, in Asians, most BCCs tend to originate as pigmented lesions (52.4%-90%) with well-defined clinical tumour borders. [4][5][6] Additionally, the local recurrence rates are low after complete excision even with close margins.…”

Section: Introductionmentioning

confidence: 99%

“…4 However, in Asians, most BCCs tend to originate as pigmented lesions (52.4%-90%) with well-defined clinical tumour borders. [4][5][6] Additionally, the local recurrence rates are low after complete excision even with close margins. In a cohort of Japanese patients with BCC, Takenouchi et al 6 reported that the 5-and 10-year recurrence rates after complete excision without use of MMS were 0.4% and 0.8%, respectively.…”

Section: Introductionmentioning

confidence: 99%

2‐mm surgical margins are adequate for most basal cell carcinomas in Japanese: a retrospective multicentre study on 1000 basal cell carcinomas

Nakamura

Matsushita

Tanaka

et al. 2020

Acad Dermatol Venereol

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Background Surgery is the gold standard for basal cell carcinomas (BCC). Current recommended surgical margins for BCCs are determined from studies in Caucasian populations. However, the appropriate surgical margins for BCCs in non‐white races are unclear. Objectives To investigate the accuracy of preoperative determination of clinical tumour borders and appropriate surgical margins in Japanese patients with BCC. Methods The maximum calculated differences in distance between the preoperatively determined surgical margins and the actual histologic tumour side margins were considered as ‘accuracy gaps’ of clinical tumour borders. Estimated side margin positivity rates (ESMPRs) with narrower (2 and 3 mm) surgical margins were calculated on the basis of the accuracy gaps. Results Overall, 1000 surgically excised BCCs from 980 Japanese patients were included. The most frequent histologic subtype was nodular BCC (67%). The median accuracy gap was 0.3 mm [interquartile range (IQR): −0.5 to +1 mm]. The ESMPRs with 2‐ and 3‐mm surgical margins were 3.8% and 1.4%, respectively. Only the ESMPRs between the well‐defined (n = 921) and poorly defined clinical tumour border groups (n = 79) showed statistical difference [2‐mm margin: 3.1% vs. 11.7%, OR: 3.89, 95% confidential interval (CI): 1.41–10.71, P <0.01; 3‐mm margin: 0.97% vs. 6.3%, OR: 6.58, 95% CI: 1.67–25.99, P <0.01]. No significant differences in ESMPRs were noted in other subgroups including risk classifications. Conclusions The determined clinical tumour border accuracy gaps in this Japanese cohort were negligible. Dermatologic surgeons may use narrower surgical margins with acceptable margin positivity rates. The clarity of clinical tumour borders could be an appropriate guide for selection of different surgical margins in the Japanese cohort.

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Narrow‐margin excision is a safe, reliable treatment for well‐defined, primary pigmented basal cell carcinoma: an analysis of 288 lesions in Japan

Abstract: Surgical excision with a 2-3-mm margin is reliable treatment for well-defined, primary pigmented BCC, with a complete removal rate of 99%.

Cited by 40 publications

References 15 publications

S2k Guidelines for Cutaneous Basal Cell Carcinoma – Part 2: Treatment, Prevention and Follow‐up

S2k Guidelines for Cutaneous Basal Cell Carcinoma – Part 2: Treatment, Prevention and Follow‐up

S2k‐Leitlinie Basalzellkarzinom der Haut – Teil 2: Therapie, Prävention und Nachsorge

2‐mm surgical margins are adequate for most basal cell carcinomas in Japanese: a retrospective multicentre study on 1000 basal cell carcinomas

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