DEMOGRAPHICS OF BASAL CELL CARCINOMA AND ITS SURGICAL MANAGEMENT
AbstractBackground: Basal cell carcinoma (BCC) is the most common, slow growing epidermal skin tumourand an increase in its incidence has been noticed in the past decades. Different treatment optionsinclude surgical and non-surgical measures. Surgical options include surgical excision, cryosurgery,curettage, electrodessication and Mohs micrographic surgery. Non-surgical treatments options are 5-flourouracil, photodynamic therapy, immunomodulation and radiotherapy. This study was conducted todetermine the demographics of facial BCC and its rate of incomplete excision and recurrence.Methods: Clinically diagnosed facial BCCs were included in this prospective descriptive study.Tumours were excised with 3–5 mm clinically palpable safe margins and were sent forhistopathological confirmation and margin clearance. All patients were followed for a minimum of twoyears to look for any recurrence. The demographic data, site, clinical presentation, size of the lesion,excision margins, reconstructive options, complications, histopathological margin clearance andrecurrence was recorded and analysed. Results: A total of 139 cases were recruited in this study. Fourcases were lost in follow-up. Out of remaining 135 patients including 78 males and 57 females with amean age of 58.6 years were studied. The commonest site of involvement was nose (45.9%), followedby periocular (28.1%) and cheek (15.6%) regions. The most common clinical type was nodular (51%)followed by ulcerative (38.5%). In majority of the cases, the resulting defect after excision wasreconstructed with local flaps (57.8%). Majority (77.8%) of tumours had histopathologically clearmargins while 20% had tumour involvement. During 2 years follow-up period, 8.9% patients hadtumour recurrence.Keywords: Basal cell carcinoma, excision, recurrence, tumour
Weshah S, Smadi R, Helalat M. Basal cell carcinoma: A
retrospective analysis of 76 patients. Pak J Med Sci
Skelton LA. The effective treatment of basal cell carcinoma: Br J
Situm M, Buljan M, Bulat V, Lugović Mihić L, Bolanca Z,
Simić D. The role of UV radiation in the development of basal
cell carcinoma: Coll Antropol 2008;32(Suppl 2):167–70.
Kyrgidis A, George Tzellos T, Vahtsevanos K, Triaridis S. New
concepts for basal cell carcinoma. Demographic, clinical,
histological risk factors and biomarkers. A systematic review of
evidence regarding risk for tumor development, susceptibility for
second primary and recurrence. J Surg Res 2008;159:545–56.
Buljan M, Bulat V, Situm M, Mihić LL, Stanić-Duktaj S.
Variations in clinical presentation of basal cell carcinoma Acta
Clin Croat 2008;47(1):25–30.
Wong CSM, Strange RC, Lear JT. Basal cell carcinoma- clinical
review. BMJ 2003;327:794–8.
Bath F, Perkins W, Bong J, Williams HC. Interventions for basal
cell carcinoma of the skin. Cochrane Database Sys Rev
Ceilley RI, Del Rosso JQ. Current modalities and new advances
in the treatment of basal cell carcinoma. Int J Dermatol
Rustemeyer J, Bremerich A. Outcomes after surgical treatment of
facial basal cell carcinomas. Acta Chir Plast 2006;48(3):89–92.
Telfer NR, Colver GB, Morton CA. Guideline for the
management of basal cell carcinoma. Br J Dermatol
Khan FT, Matthews RL. An audit of incompletely excised basal
cell carcinoma. Ann King Edward Med Uni 1999;5(3):288–90.
Shah SA, Obaidullah, Fahimullah. An Assessment of incomplete
facial basal cell carcinoma excision. J Col Phys Surg Pak
Memon GA, Memon AR, Kumar M. Basal Cell Carcinoma in
our population: a study of 21 years experience. J Liquat Uni Med
Health Sci 2002;1(1):7–10.
Smeets NW, Kuijpers DI, Nelemans P, Ostertag JU, Verhaegh
MEJH, Krekels GAM et al. Mohs’ micrographic surgery for
treatment of basal cell carcinoma of the face –results of a
retrospective study and review of the literature. Br J Dermatol
Lalloo MT, Sood S. Head and neck basal cell carcinoma:
treatment using 2 mm clinical excision margin. Clin Otolaryngol
Allied Sci 2000;25:370–3.
Rustemeyer J, Thieme V, Günther L, Bremerich A. Experiences
with surgical management of facial basal cell carcinoma and
procedures for plastic reconstruction. Mund Kiefer Gesichtschir
Rubin AI, Chen EH, Ratner D. Basal Cell Carcinoma. N Engl J
Spraul CW, Ahr WM, Lang GK. Clinical and histologic features
of 141 primary basal cell carcinomas of the periocular region and
their rate of recurrence after surgical excision. Klin Monatsbl
Bath-Hextall F, Bong J, Perkins W, Williams H. Interventions for
basal cell carcinoma of the skin: systematic review. BMJ
Walker P, Hill D. Surgical treatment of basal cell carcinomas
using standard postoperative histological assessment. Australas J