Correlation of basal cell carcinoma subtype with histologically confirmed subclinical extension during Mohs micrographic surgery: A prospective multicenter study

Lim, Geoffrey F.S.; Pérez, Oliver; Zitelli, John A.; Brodland, David G.

doi:10.1016/j.jaad.2022.02.037

Cited by 9 publications

(6 citation statements)

References 54 publications

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“…25 Therefore, some scholars believed that MMS is more suitable for superficial BCC. 26 Although the results of the naked eye boundary and the dermoscopic observation boundary in our study were mostly consistent, there were still 16.8% of patients whose visual margin was insufficient to the dermoscopy-detected margin, which may lead to the possibility of tumor residual. Our results showed that as the margin of peripheral surgical margins increased, the rate of complete excision increased, and was found to be 95.8% for the 2 mm histopathologic negative margin, and 99.5% of the 4 mm margin.…”

Section: Discussionsupporting

confidence: 67%

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The effect of dermoscopy in assisting on defining surgical margins of basal cell carcinoma

Chen

Liu

Zhou

et al. 2022

Dermatologic Therapy

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To investigate the diagnostic value of dermoscopy in defining the tumor margin of basal cell carcinoma (BCC) for the appropriate surgical margin. A total of 107 BCC patients were enrolled for this study. The tumor boundaries were observed by naked eye and dermoscope respectively, and 5 mm outward was used as surgical margin according to the dermoscopy-defined margin. Pathological examinations were performed at 2 mm intervals in the direction previously marked and the effect was assessed accordingly. There were still 16.8% of patients whose visual margin was insufficient to the dermoscopy-detected margin. With 2 mm excision margin from the dermoscopy-guided tumor margin, excision range in 12 patients (11.2%) proved to be inadequate, but only 18 surgical margins (4.2%) in the whole 428 excision margin specimens proved to be tumor-positive. While with 4 mm margin, residual lesion was observed in 2 (0.5%) of 107 BCC patients, and positive margin was found in 2 (0.3%) of 428 margin specimen. There has been no recurrence in our study so far.Dermoscopy is superior to visual inspection for defining BCC tumor margin. Under preoperative dermoscopy detection, a 4 mm excision margin of BCC can achieve a radical resection rate of 98.1%, and 92.3% for a 2 mm excision margin of pigmented BCC.

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Section: Discussionsupporting

confidence: 67%

“…Superficial BCCs had more frequently extended subclinically than the other subtype BCC and was leading to wider surgical margins and more stages 25 . Therefore, some scholars believed that MMS is more suitable for superficial BCC 26 …”

Section: Discussionmentioning

confidence: 99%

The effect of dermoscopy in assisting on defining surgical margins of basal cell carcinoma

Chen

Liu

Zhou

et al. 2022

Dermatologic Therapy

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“…Another study conducted by Fung-Soon Lim et al divided the histopathological subtypes of BCC based on the risk of subclinical extension into two categories: high risk (morpheaform, infiltrative, metatypical, mixed and superficial) and low risk (basosquamous, micronodular, nodular and unspecified) [ 20 ]. These aspects are important for a clinician to evaluate the relapse risk after tumour excision.…”

Section: Discussionmentioning

confidence: 99%

Basal Cell Carcinoma—A Retrospective Descriptive Study Integrated in Current Literature

Giuglea

Marin

Gavrila

et al. 2023

Life

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Basal cell carcinoma (BCC) is considered to be the most common cancer in humans. It has a slow growth rhythm, and for this reason, metastases are rare. For our retrospective study, we selected 180 patients from those who underwent surgery for a variety of skin tumours between January 2019 and August 2022 and whose histopathological examination revealed basal cell carcinoma. All surgeries were performed by plastic surgeons at the “St. John” hospital in Bucharest. The aim of this article is to provide observational data regarding BCC—in terms of histopathology and diagnostic and therapeutic management and to integrate these data into the current knowledge of this pathology.

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“…We investigated whether the appearance of recurrence is associated with the initial size of the BCC, the anatomic site, histopathologic subtype, or patient's age. Although none of these associations was statistically significant, a noteworthy finding was that 7 of 14 recurrent BCCs were located on the nose (Table 4) [17].…”

Section: Resultsmentioning

confidence: 95%

Real-Life Data on the Management of Incompletely Excised Basal Cell Carcinoma

et al. 2023

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Backround : The histopathologic presence of basal cell carcinoma (BCC) cells at one or more margins of the specimen after surgical excision is considered suggestive of incomplete tumor clearance. The management of incompletely excised BCC might vary in different clinical scenarios from re-excision to application of other treatmenents or even watchful waiting. Objective: Τo report the real-life management of incompletely excised BCC in a tertiary referral center and compare the recurrence rates according to the selected management modality. Methods: A retrospective study was conducted at a tertiary Dermatology Center in Northern Greece. Our electronic database was scanned over a 5-year period to retrieve all BCCs with available histopathologic assay reporting at least one involved margin (lateral or deep). The included patients were divided into 3 groups according to the selected management after incomplete excision: group 1 included those who underwent immediate re-excision (n=26), group 2 those who were followed-up without any additional therapy (n=40) and group 3 those who were treated with adjuvant/complementary non-surgical treatment (n=18). Finally, we recorded the presence or absence of residual tumor in the new histopathologic report of those tumors that were selected to be re-excised (group 1). The primary outcome was the appearance of clinical tumor recurrence. Results: Of 1689 BCCs recorded in our database, 84 met the inclusion criteria and were included in the analysis. Re-excision had been selected in 26 of 84 patients (group 1), watchful waiting in 40 (group 2) and non-surgical treatments in 18 (group 3). The histopathologic reports of the 26 tumors of group 1 that were re-excised revealed residual tumor in 14 (53.8%) cases. Overall, a clinical recurrence occurred in 14 of 84 patients (16.7%) after a mean follow up of 17 months. The median time to recurrence was 14 months. Of 40 patients without any treatment, recurrence developed in 10 (25%), while only 2 of 18 patients treated with non-surgical treatments recurred (11.1%). Conclusions: Our study suggests that positive histopathologic margins after BCC excision result in a clinical recurrence only in a proportion of patients. This percentage is higher when no further treatment is applied and lower when the area is re-excised or treated with imiquimod alone or combined with cryotherapy.

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Correlation of basal cell carcinoma subtype with histologically confirmed subclinical extension during Mohs micrographic surgery: A prospective multicenter study

Cited by 9 publications

References 54 publications

The effect of dermoscopy in assisting on defining surgical margins of basal cell carcinoma

The effect of dermoscopy in assisting on defining surgical margins of basal cell carcinoma

Basal Cell Carcinoma—A Retrospective Descriptive Study Integrated in Current Literature

Real-Life Data on the Management of Incompletely Excised Basal Cell Carcinoma

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