Recurrent Basal Cell Carcinoma After Incomplete Resection

Robinson, June K.; Fisher, Susan G.

doi:10.1001/archderm.136.11.1318

Cited by 96 publications

(77 citation statements)

References 24 publications

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“…by electrocautery, disappearing after surgery. 14 Spontaneous regression of residue BCC at the margin has been reported 24 and was thought to be related to the presence of a weak host response mediated by lymphocytes infiltrating the tumor. 25 Other investigators 26,27 have reported that residual BCC was present in 37% of patients after treatment with curettage and electrodesiccation, and that there was no sign of regression after 1 and 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…The practice of some experts in the field has been not to perform a second resection in cases of positive excision margins, since the probability of recurrence is limited. 14 Berlin et al 30 recommended clinical follow-up for patients with a very low risk of recurrence, while Nagore et al 11 recommended immediate re-excision in cases in which the resection margins were positive.…”

Section: Discussionmentioning

confidence: 99%

“…13 These reports favor a conservative "wait and see" policy that includes the need for conscientious postoperative follow-up. 14 Management of incompletely excised BCC remains a matter of debate. 15 Nevertheless, it is important to preserve as much normal tissue as possible, particularly in the periocular region, thus optimizing the possibility of achieving good esthetic results with minimal intervention.…”

Section: Introductionmentioning

confidence: 99%

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Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence?

Jankovic

Kovačević

Visnjic

et al. 2010

An. Bras. Dermatol.

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Introduction: Basal cell carcinoma is the most common tumor of the eyelid. In this region, reconstruction is complex and damage to healthy tissue should be minimal. Objective: To define the relationship between margin clearance at excision and the recurrence rate of basal cell carcinoma of the eyelid. Methods: This prospective study was conducted with 111 patients submitted to surgery for basal cell carcinoma of the eyelid between 2001 and 2003 and followed up for a period of five years. The patients were evaluated according to age, tumor site, recurrence rate and margin clearance at excision. Results: No significant association was found between incomplete tumor excision and recurrence except in patients under 56 years of age, female patients and in the case of tumors of the medial canthus. Conclusion: A risk of recurrence in incompletely excised basal cell carcinomas of the eyelid was only confirmed in younger patients, females and for tumors of the medial canthus. Keywords: Basal cell carcinoma; eyelid; recurrence.Resumo: Introdução: O carcinoma basocelular é o tumor mais comum entre os tumores das pálpebras. Nesta região, a reconstrução é complexa e recomenda-se que haja perda mínima de tecido saudável. Objetivo: Para definir a relação entre margem livre de tumor na excisão e taxa de recidiva do carcinoma basocelular das pálpebras. Métodos: Este estudo prospectivo incluiu 111 pacientes operados para remoção de carcinoma basocelular das pálpebras no período de 2001 a 2003, com acompanhamento subsequente de 5 anos. Os pacientes foram avaliados de acordo com a idade, localização do tumor, taxa de recidiva, e margem livre de tumor na excisão. Resultados: Não se encontrou associação significativa entre a excisão incompleta do tumor e casos de recidiva, exceto em pacientes com idade inferior a 56 anos, pacientes do sexo feminino e em tumores do canto medial. Conclusão: Um risco maior de recidiva de carcinoma basocelular das pálpebras com excisão incompleta foi confirmado estatisticamente apenas em pacientes mais jovens, em mulheres, e nos tumores do canto interno.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence?

Jankovic

Kovačević

Visnjic

et al. 2010

An. Bras. Dermatol.

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“…The latent period between surgery and onset of recurrence varies, on average, from two months to two years; however, it occurs more frequently in the first six months, but there are reports of more than five years. [153][154][155][156][157] Surgical excisions with positive margins recur in 15% to 67% of cases; however, they may occur after the report of histopathologically free margins (1.3 to 4.0%). This occurs more commonly in multifocal superficial and sclerodermiform tumors.…”

Section: Prognosismentioning

confidence: 99%

Epidemiologia do carcinoma basocelular

Chinem

Miot

2011

An. Bras. Dermatol.

124

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Basal cell carcinoma is the most common malignant neoplasm in humans and its incidence has increased over the last decades. Its high frequency significantly burdens the health system, making the disease a public health issue. Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity. Exposure to ultraviolet radiation is the main environmental risk factor associated with its cause. However, other elements of risk are described, such as light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blond hair, freckles in childhood and immunosuppression. Behavioral aspects such as occupational sun exposure, rural labor and sunburns at a young age also play a role. Between 30% and 75% of the sporadic cases are associated with patched hedgehog gene mutation, but other genetic changes are also described. The tumor is commonly found in concomitance with skin lesions related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. The prevention of basal cell carcinoma is based on the knowledge of risk factors, early diagnosis and treatment, as well as on the adoption of specific measures, particularly in susceptible populations. The authors present a review of the epidemiology of basal cell carcinoma. Keywords: Injections, intradermal; Review; Skin; Therapeutics Resumo: O carcinoma basocelular é a neoplasia maligna mais comum em humanos e sua incidência vem aumentando nas últimas décadas. Sua grande frequência gera significativo ônus ao sistema de saúde, configurando problema de saúde pública. Apesar das baixas taxas de mortalidade e de rara ocorrência de metástases, o tumor pode apresentar comportamento invasivo local e recidivas após o tratamento, provocando importante morbidade. Exposição à radiação ultravioleta representa o principal fator de risco ambiental associado a sua gênese. Entretanto, descrevem-se outros elementos de risco: fotótipos claros, idade avançada, história familiar de carcinomas de pele, olhos e cabelos claros, sardas na infância e imunossupressão, além de aspectos comportamentais, como exercício profissional exposto ao sol, atividade rural e queimaduras solares na juventude. Entre 30% e 75% dos casos esporádicos estão associados à mutação do gene patched hedgehog, mas outras alterações genéticas são ainda descritas. A neoplasia é comumente encontrada concomitantemente com lesões cutâneas relacionadas à exposição solar crônica, tais como: queratoses actínicas, lentigos solares e telangiectasias faciais. A prevenção do carcinoma basocelular se baseia no conhecimento de fatores de risco, no diagnóstico e tratamento precoces e na adoção de medidas específicas, principalmente, nas populações susceptíveis. Os autores apresentam uma revisão da epidemiologia do carcinoma basocelular.

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“…The presence of positive margins in the permanent pathology of the tumour does not always imply tumour recurrence. Nevertheless, immediate reexcision is the best option in incompletely excised high-risk NMSCs, although close clinical follow-up may be reasonable for a selected group of patients with low-risk NMSCs [10,23]. The relative risk of incomplete excision of NMSC is approximately 2.5-fold higher when it is located on the nose compared with the rest of the skin surface [8]; and the rate of incomplete excision of NMSC of the nose is 5.5-38% [8,12,19].…”

Section: Discussionmentioning

confidence: 99%

Staged-surgery with permanent pathology for the management of high-risk nonmelanoma skin cancer of the nose

Eskıızmır

Gençoğlan

Temız

et al. 2010

Eur Arch Otorhinolaryngol

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The objective of the study was to investigate the effect of staged-surgery with permanent pathology on tumour recurrence of high-risk nonmelanoma skin cancers (NMSCs) of the nose and to determine the factors associated with subclinical spread and deep-margin involvement. Twenty-one patients who underwent staged-surgery with permanent pathology for high-risk NMSCs of the nose between 2007 and 2008 were prospectively followed-up for tumour recurrence. The incidence of tumour recurrence after staged-surgery with permanent pathology was 0%. A positive correlation between perineural involvement and subclinical spread (p = .012); and a statistically significant relationship between infiltrative type basal cell carcinoma (BCC) and deep-margin involvement (p = .033) was detected. Staged-surgery with permanent pathology is a reliable surgical method for complete excision of high-risk NMSCs of the nose and provides a significant decrease in tumour recurrence. Perineural involvement may cause subclinical spread, and infiltrative type BCC may invade deeper structures of the nose.

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Recurrent Basal Cell Carcinoma After Incomplete Resection

Cited by 96 publications

References 24 publications

Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence?

Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence?

Epidemiologia do carcinoma basocelular

Staged-surgery with permanent pathology for the management of high-risk nonmelanoma skin cancer of the nose

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