Predicting incomplete basal cell carcinoma excisions – a large multidisciplinary retrospective analysis in a tertiary center

Abstract

INTRODUCTION Surgical treatment of basal cell carcinomas is often performed by physicians with different surgical backgrounds. Collecting data from different surgical departments would better reflect their real-life surgical management. OBJETIVES To identify the rate, recurrence risk and predictive factors accordingly to their relative contribution for an incomplete basal cell carcinoma excision in a large multidisciplinary real-life setting METHODS Retrospective cohort study of 2305 surgically treated lesions in different departments of a tertiary center RESULTSThere was a rate of incomplete excisions (15%) and a recurrence rate (35.5% vs 6.8% in incomplete vs complete excisions (p <0.001)) A third of incompletely excised BCCs will recur over time. Stratified by relevancy, high-risk histological subtypes (micronodular (OR 5.10p <0.001) and morpheaform (OR 5.42 -p<0.001), smaller specimen sizes (<0.5 cm or 0.5 to 1 cm, OR 3.99 and 2.49, respectively, p<0.001) high-risk locations (OR 3.06 on the nose, OR 2.77 on the eyelids, p <0.001) and recurrent BCCs (OR 1.72, p<0.001). are the best predictors of an incomplete excision.

Clinicopathological Factors Associated with Incomplete Excision of High-risk Basal Cell Carcinoma

“…In other studies that have specified IERs for aggressive subtypes, the rates were 9.5–50.0% ( 11 – 17 , 19 – 22 , 24 , 27 , 28 ). Eight of these studies included <200 lesions ( 14 , 15 , 19 – 22 , 24 , 27 ), 4 included an unknown number of lesions ( 13 , 17 , 18 , 28 ), 1 included 275 lesions ( 11 ) and the largest study by Kappelin et al ( 12 ) included 773 lesions. In the current study, the IER was 20.6% for all high-risk tumours: 27.3% for type III and 17.6% for type II.…”