Significance of Marginal Extension in Excised Basal-Cell Carcinoma

Gooding, Charles A.; White, George L.; Yatsuhashi, Masao

doi:10.1056/nejm196510212731708

Cited by 154 publications

(79 citation statements)

References 2 publications

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“…These findings are in agreement with other studies which show recurrence rates of 25-35% for incompletely removed tumours (Taylor & Barisoni 1973;Koplin & Zarem 1980;Doxanas et al 1981;Gooding et al 1965). We believe that by using the simple classification presented in this paper communication between the pathologist and the surgeon may be improved and the pathologists' report may be used as a guideline for further treatment.…”

Section: Discussionsupporting

confidence: 92%

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Sigurðsson

Agnarsson

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To examine all basal cell carcinomas of the eyelid diagnosed in Iceland during a 25-year period, paying special attention to the surgical margins of excision in relation to recurrence. Based on the results a simple, clinically relevant method of classifying the surgical margin is proposed. Methods: All histologically proven basal cell cancer specimens from eyelids were reviewed retrospectively. The surgical excision margins were classified as radical, marginal or intralesional. Results: Recurrence risk was low when the tumor had a surgical margin described as radical or marginal. The recurrence rate was 38% when the margin was intralesional. Conclusion: By assessing the surgical margins by this method, which is easy to apply, better understanding between the pathologist and the surgeon may be achieved.

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Section: Discussionsupporting

confidence: 92%

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Sigurðsson

Agnarsson

1998

Acta Ophthalmologica Scandinavica

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“…Although considerations for creating a smaller surgical scar on the face might have affected creating the narrow margins, other considerations such as inability to clini- cally determine the margin of tumor or wanting to limit postoperative recovery in the elderly all contributed to incomplete resection, which was the entry criterion for this study (Table 3). Many observers [1][2][3][4][5][7][8][9][10] have shown that incompletely removed primary BCC did not clinically recur within 5 or 10 years 6 ; however, the peak incidence of recurrence in many studies was at 2 years. [1][2][3]5,6,9 Those espousing the conservative "wait and see" policy placed great emphasis on the need for conscientious postoperative follow-up.…”

Section: Commentmentioning

confidence: 99%

“…Many observers [1][2][3][4][5][7][8][9][10] have shown that incompletely removed primary BCC did not clinically recur within 5 or 10 years 6 ; however, the peak incidence of recurrence in many studies was at 2 years. [1][2][3]5,6,9 Those espousing the conservative "wait and see" policy placed great emphasis on the need for conscientious postoperative follow-up. 5,6 Given the slow-growth characteristics of BCC, which clinically doubles in size in about 6 months, 20 and the relatively asymptomatic nature of tumor growth, clinical recurrence was difficult to ascertain from patients' observations.…”

Section: Commentmentioning

confidence: 99%

“…[1][2][3]5,6,9 Those espousing the conservative "wait and see" policy placed great emphasis on the need for conscientious postoperative follow-up. 5,6 Given the slow-growth characteristics of BCC, which clinically doubles in size in about 6 months, 20 and the relatively asymptomatic nature of tumor growth, clinical recurrence was difficult to ascertain from patients' observations. Because many patients with incompletely excised BCC were elderly and have impaired vision and cognitive functions, patients may not be reliable observers to report a recurrence.…”

Section: Commentmentioning

confidence: 99%

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Recurrent Basal Cell Carcinoma After Incomplete Resection

Robinson¹,

Fisher²

2000

Arch Dermatol

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“…Those favoring the "wait and see" method pointed out that only a minority of patients will develop recurrent disease and, if follow-up is diligent, supplementary treatment at that stage will keep the disease under control (Gooding et al 1965;Casson 1980;Huynh and Veness 2002;Wilson et al 2004;Wettstein et al 2006;Rogalski et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Incompletely excised basal cell carcinomas: Our guidelines

Serra¹

2008

OTT

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A retrospective review of 982 patients treated for basal cell carcinoma (BCC) was conducted over a period of 8 years from 1996 to 2004. Of these patients, 16 presented a margin involvement. Two cohorts of patients with involved margin were identifi ed: the group whose basal cell carcinoma was re-excised, and the "wait and see" group. Both sets of results obtained were compared, and then matched with recent international literature reviews. Reexcision is our current practice for incompletely excised tumor. However during the period examined only 36 patients of 116 with margin involvement, proceeded to re-excision, and of the remaining 80 patients just 39 were followed-up. The others were missed mainly because of the diffi culty of attending follow-up consultations because of advanced age, poor general conditions, and unavailability of transport facilities. On the basis of several points, including a high number of residual tumors detected in the re-excised patients, and diffi culty in maintaining diligent follow-up in the "wait and see" group, we stress the importance of considering an early re-excision in case of margin involvement (focal, lateral, or deep), to avoid a signifi cant risk of recurrence. In this study 16 patients out of 39 in the "wait and see" group had recurrences over 8 years of follow-up; a signifi cant number of recurrences was observed after 5 years. We therefore reserve a clinical follow-up only for patients in whom poor general health dissuades us from re-operation.

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Significance of Marginal Extension in Excised Basal-Cell Carcinoma

Cited by 154 publications

References 2 publications

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Recurrent Basal Cell Carcinoma After Incomplete Resection

Incompletely excised basal cell carcinomas: Our guidelines

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