The influence of embryology of the mid‐face on the spread of epithelial malignancies

Panje, William R.; Ceilley, Roger I.

doi:10.1288/00005537-197912000-00003

Cited by 139 publications

(77 citation statements)

References 3 publications

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“…Overall, neoplastic margin involvement at histological examination was present in 17% (122 lesions) of excisions in our cases, with a 6.5-20.7% range as reported in the literature (23). The global recurrence rate assessed (14.7%) was within the 5-19% range reported in most previous studies (7)(8)(9)11,12,27). Regarding surgical excision, a 38.5% recurrence was noted when histological analysis showed an infiltration (lateral, deep or both margins infiltration), while a 25.5% recurrence rate for lesions with suboptimal excision can be expected and a 8.4% recurrence with histologically confirmed optimal excision, nevertheless, was recorded during the follow-up.…”

Section: Discussionsupporting

confidence: 72%

“…According to the literature, surgically excised primary BCCs may show a recurrence rate that varies from 5 to 14% (7)(8)(9)(10)(11)(12). The rates of recurrence appear to depend, to a large extent, on the anatomical localization, the histological characteristics, the initial treatment strategy and the eventual neoplastic margin involvement.…”

Section: Introductionmentioning

confidence: 99%

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Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Sartore

Lancerotto²,

Salmaso³

et al. 2011

Oncol Rep

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Abstract. Rates of recurrence after incomplete surgical excision of basal cell carcinoma (BCC) range from 4 to 16.6% of analyzed cases. The aim of the present study was to identify the predictive factors associated with facial BBC recurrence following excision and their influences, in order to establish a proper therapeutic strategy. A monocentric retrospective study was performed reviewing all BCCs surgically excised at the Institute of Plastic Surgery, University of Padua, with particular focus on the involvement of surgical margins and recurrence. Seven hundred and nineteen lesions in 605 patients were studied. Correlations between recurrence probability and various characteristics of BCC were analyzed using a logistic regression model. It was observed that incomplete excision, deep margin involvement, the presence of sclerodermiform or metatypic basaloid squamous cells, as well as pleomorphous histological variants and/or peritumoral inflammatory infiltrates, were all related to an increase in the probability of recurrence. BCC excision must be followed by individualized management with particular consideration for the localization, the histological type and other known predisposing factors; the treatment strategy and, in particular, the length of the surveillance period and the frequency of patient assessment should be evaluated on the basis of the recurrence probability outlined.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Sartore

Lancerotto²,

Salmaso³

et al. 2011

Oncol Rep

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“…58 For the studies of treatments of BCC, the heterogeneity is large. From the literature, it is known that the risk for the recurrence of a treated BCC depends not only on the treatment modality but also on the location 59,60 ; on the size and histologic subtype of the tumor 61,62 ; and to a lesser degree, on patient-specific aspects such as age, immune status, and sex. 63 Especially with the micronodular, adenoid, and morphea subtypes of BCC and tumors localized in the H figure (danger zone) of the face, those larger than 2 cm are associated with a higher risk for recurrence.…”

Section: Effectiveness or Recurrence Ratesmentioning

confidence: 99%

A Systematic Review of Treatment Modalities for Primary Basal Cell Carcinomas

Thissen¹,

Neumann²,

Schouten³

1999

Arch Dermatol

346

257

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“…4 Additionally, NMSCs are notorious for infiltration along perichondrium, periosteum, and the vasculature. 12 Consequently, active disease can remain in these areas if it is not addressed during surgical removal and can be a source of recurrences after multiple attempts at surgical extirpation. As a result, skull base involvement complicates a surgical strategy to obtain margins and is an important consideration in obtaining acceptable surgical and oncological outcomes.…”

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confidence: 99%

Nonmelanoma cutaneous cancers involving the skull base: outcomes of aggressive multimodal management

Raza¹,

Ramakrishna²,

Weber

et al. 2015

JNS

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R epResenting the most common human neoplasm, skin cancers occur in the head and neck region in nearly 90% of cases due to sun exposure. Of these, nonmelanoma skin cancers (NMSCs) pose a unique set of challenges. Basal cell carcinoma (BCC) is the most common malignancy in this area, with squamous cell carcinoma (SCC) second in frequency. BCC is characterized by its propensity for local aggressive growth and the capacity to reach large sizes (greater than 2 cm). SCC is the second most common cutaneous malignancy and is differentiated from BCC by its tendency to spread to regional lymph nodes (15% in tumors greater than 2 cm) and for perineural invasion (2%-15%). While considered a histological subtype of BCC, basosquamous carcinoma (BSCC) is abbreviatioNs BCC = basal cell carcinoma; BSCC = basosquamous cell carcinoma; CN = cranial nerve; MDACC = MD Anderson Cancer Center; NMSC = nonmelanoma skin cancer; OS = overall survival; PFS = progression-free survival; SCC = squamous cell carcinoma. obJect A relative paucity of information exists regarding outcomes from craniofacial resection for advanced nonmelanoma skin cancers involving the skull base. In light of advances in surgical technique and adjuvant therapy protocols, the authors reviewed their surgical experience to determine disease control rates, overall survival (OS), morbidity, and mortality. methods A retrospective review of 24 patients with nonmelanoma cutaneous cancers with skull base involvement treated with craniofacial resection at The University of Texas MD Anderson Cancer Center from 1994 to 2012 was performed. Of these patients, 19 (79%) had squamous cell carcinoma (SCC), 4 (17%) had basosquamous carcinoma (BSCC), and 1 patient (4%) had adenocarcinoma. Factors as assessed were prior treatment, TNM staging, tumor involvement, extent of intracranial extension, margin status, postoperative complications, recurrence, disease status at last follow-up, and long-term survival. The majority of tumors were T4 (67%) according to the TNM classification; perineural extension was noted in 58%, cavernous sinus involvement in 25%, and dural involvement in 29%. results Postoperative complications occurred in 4 patients (17%) including 1 death. Kaplan-Meier estimates were calculated for OS and progression-free survival (PFS). Median OS was 43.2 months with an 82% 1-year OS and 37% 5-year OS; the median PFS was 91.2 months. Margin status was positively associated with median OS in SCC (91 months [for negative margins] vs 57 months, p = 0.8) and in BSCC (23.7 vs 3.2 months, p < 0.05). Postoperative radiotherapy was associated with improved median OS (43.2 vs 22 months, p = 0.6). Brain involvement was uniformly fatal after 1 year, while cavernous sinus involvement (31 vs 43 months, p = 0.82), perineural disease (31 vs 54 months, p = 0.30), and T4 stage (22 vs 91.2 months, p = 0.09) were associated with worsened OS. Similar associations were found with median PFS. coNclusioNs Aggressive multimodality management with surgery and postoperative radiotherapy can positively...

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The influence of embryology of the mid‐face on the spread of epithelial malignancies

Cited by 139 publications

References 3 publications

Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

Facial basal cell carcinoma: Analysis of recurrence and follow-up strategies

A Systematic Review of Treatment Modalities for Primary Basal Cell Carcinomas

Nonmelanoma cutaneous cancers involving the skull base: outcomes of aggressive multimodal management

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