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

Abstract

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.

Basal Cell Carcinoma of the Head and Neck Region: A Retrospective Analysis of Completely Excised 331 Cases

“…BCC is the most common type of skin cancer in Caucasians, which predominantly occurs on the exposed parts of the body, with 75–85% of the lesions found in the head and neck regions [1, 2, 6–9]. According to our findings, more than half of the lesions are found in the nose (32.3%), orbital (19.1%), and cheek (18.1%) areas which are the most central and prominent parts of the entire head and neck region.…”

“…It has been shown that the recurrence rate for primary BCCs after surgical excision varies between 5% and 14% [1, 5]. Lesions in the head and neck region are at more risk for recurrence, when compared to lesions in trunk and extremities [1, 5, 7, 23].…”

“…Lesions in the head and neck region are at more risk for recurrence, when compared to lesions in trunk and extremities [1, 5, 7, 23]. Even though some factors, like anatomical localization, histopathological characteristics, and initial treatment strategy, have been proposed, there is lack of accepted understanding in the recurrence of the lesions [6].…”

“…The incidence of BCC is on the rise, and it represents approximately 65% of all skin carcinomas [1–3]. BCC is not usually life threatening, unlike malignant melanoma, but it is locally invasive and may lead to considerable morbidity and complications [4].…”

“…Recurrence is more common, especially with positive peripheral margins and certain types of BCC, like morpheaform forms. Recurrent BCC tends to be biologically more aggressive than primary lesions [1]. Positive surgical margins in primary BCC excisions in the head and neck region were reported to be 3–20% in the literature [5].…”