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

Abstract

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.

Head and neck cutaneous basal cell carcinoma: what should the otorhinolaryngology head and neck surgeon care about?

“…Alternatively, MMS may be performed for complete tumour excision and tissue sparing, taking into account tumour size and location, as well as the aggressiveness of the cBCC 84 . A feasible and pragmatic algorithm for surgical management of primary and recurrent cBCC is presented in Figure 3 85,86 . Surgical excision is fast, inexpensive and well accepted, and usually has good long-term functional and aesthetic outcomes.…”

Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma

“…9 Although non-surgical techniques are accepted for some cases of BCCs, they were not covered in this study.…”

High-Risk Basal Cell Carcinomas of the Head and Neck: Selected Successful Surgical Approach in Three Bulgarian Patients!

“…Because of the specific anatomical features and difficult surgical techniques in the H-zone of the face (i.e. nasolabial fold, nasal alar, orbital area and auricular area), and next to it, often it comes to narrow excision margins and inability to follow the recommended surgical margins of 4mm for small, primary, well-defined basal cell carcinomas and 5-6 mm for high-risk and recurrent tumours (as in case 2) [2], [3], [4]. It is believed that incompletely excised BCCs are most likely to recur [5].…”