Incompletely Excised Basal Cell Carcinoma: Residual Tumor Rates at Mohs Re-Excision

Palmer, Vanessa M.; Wilson, Perry

doi:10.1111/dsu.12113

Cited by 19 publications

(14 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Palmer et al 40 have re-operated incompletely excised BCCs with MMS in a mean time of 11 weeks, and found histological evidence of residual tumor in 69% of the cases. The presence of clinically visible tumors at the time of re-excision was associated with an unexpectedly large number of required stages.…”

Section: Resultsmentioning

confidence: 99%

Surgical treatment of basal cell carcinoma: an algorithm based on the literature

Luz

Ferron

Cardoso

2015

An. Bras. Dermatol.

View full text Add to dashboard Cite

Although basal cell carcinoma can be effectively managed through surgical excision, the most suitable surgical margins have not yet been fully determined. Furthermore, micrographic surgery is not readily available in many places around the world. A review of the literature regarding the surgical treatment of basal cell carcinoma was conducted in order to develop an algorithm for the surgical treatment of basal cell carcinoma that could help the choice of surgical technique and safety margins, considering the major factors that affect cure rates. Through this review, it was found that surgical margins of 4mm seem to be suitable for small, primary, well-defined basal cell carcinomas, although some good results can be achieved with smaller margins and the use of margin control surgical techniques. For treatment of high-risk and recurrent tumors, margins of 5-6 mm or margin control of the surgical excision is required. Previous treatment, histological subtype, site and size of the lesion should be considered in surgical planning because these factors have been proven to affect cure rates. Thus, considering these factors, the algorithm can be a useful tool, especially for places where micrographic surgery is not widely available.

show abstract

Section: Resultsmentioning

confidence: 99%

Surgical treatment of basal cell carcinoma: an algorithm based on the literature

Luz

Ferron

Cardoso

2015

An. Bras. Dermatol.

View full text Add to dashboard Cite

show abstract

“…The preparation usually takes 20 to 60 min per excision, 8,9 during which the patient waits, and the entire cycle is repeated until a tumor-free plane is achieved. Studies have shown that, depending on the setting, more than half of the cases can show residual tumor after the first excision, [10][11][12] resulting in additional Mohs stages. Consequently, the overall Mohs procedure lasts for at least 1 to 2 h, can take several more hours in some cases, and is tedious and inefficient.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative imaging during Mohs surgery with reflectance confocal microscopy: initial clinical experience

Flores¹,

Córdova²,

Kose³

et al. 2015

J. Biomed. Opt

View full text Add to dashboard Cite

Abstract. Mohs surgery for the removal of nonmelanoma skin cancers (NMSCs) is performed in stages, while being guided by the examination for residual tumor with frozen pathology. However, preparation of frozen pathology at each stage is time consuming and labor intensive. Real-time intraoperative reflectance confocal microscopy (RCM), combined with video mosaicking, may enable rapid detection of residual tumor directly in the surgical wounds on patients. We report our initial experience on 25 patients, using aluminum chloride for nuclear contrast. Imaging was performed in quadrants in the wound to simulate the Mohs surgeon's examination of pathology. Images and videos of the epidermal and dermal margins were found to be of clinically acceptable quality. Bright nuclear morphology was identified at the epidermal margin and detectable in residual NMSC tumors. The presence of residual tumor and normal skin features could be detected in the peripheral and deep dermal margins. Intraoperative RCM imaging may enable detection of residual tumor directly on patients during Mohs surgery, and may serve as an adjunct for frozen pathology. Ultimately, for routine clinical utility, a stronger tumor-to-dermis contrast may be necessary, and also a smaller microscope with an automated approach for imaging in the entire wound in a rapid and controlled manner. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

show abstract

“…Complete excision of BCC should always be the goal of surgical treatment; however, incomplete excision of BCC is frequent. Reported rates of incomplete excision after routine excision range from 1.9% to 16% . Recently, Walker and Hill reviewed 5‐year follow‐up studies and found an average of 38% recurrence rate (range 19–100%) after incomplete BCC excision .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical removal with histologic control of excision margins usually represents the first choice in the treatment of BCC and is the most widely used option with the best outcome . Despite careful evaluation of tumor margins, incomplete excision of BCC is common.…”

mentioning

confidence: 99%

“…showed that 24% of incompletely excised BCCs present with increased aggressive course on recurrence, especially if located in the nasal and periauricular regions . Furthermore, the recurrence of BCC after incomplete surgical excision or less effective nonsurgical options may lead to the formation of areas of scar tissue in which recurring BCC may be difficult to distinguish from surrounding healthy skin .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of in vivo photodiagnosis for the identification of tumor margins in recurrent basal cell carcinoma of the face

Borroni

Barruscotti

Carugno

et al. 2015

Photoderm Photoimm Photomed

View full text Add to dashboard Cite

show abstract

Incompletely Excised Basal Cell Carcinoma: Residual Tumor Rates at Mohs Re-Excision

Cited by 19 publications

References 48 publications

Surgical treatment of basal cell carcinoma: an algorithm based on the literature

Surgical treatment of basal cell carcinoma: an algorithm based on the literature

Intraoperative imaging during Mohs surgery with reflectance confocal microscopy: initial clinical experience

Usefulness of in vivo photodiagnosis for the identification of tumor margins in recurrent basal cell carcinoma of the face

Contact Info

Product

Resources

About