DEMOGRAPHICS OF BASAL CELL CARCINOMA AND ITS SURGICAL MANAGEMENT

Authors

  • Riaz Ahmed Khan Afridi
  • Ehtisham Ahmed
  • Shahbaz Ali Khan
  • Asghar Ali

Abstract

Background: 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

References

Weshah S, Smadi R, Helalat M. Basal cell carcinoma: A

retrospective analysis of 76 patients. Pak J Med Sci

;23(4):556–60.

Skelton LA. The effective treatment of basal cell carcinoma: Br J

Nurs 2009;18:346–50.

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

;(1):CD003412.

Ceilley RI, Del Rosso JQ. Current modalities and new advances

in the treatment of basal cell carcinoma. Int J Dermatol

;45:489–98.

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

;159:35–48.

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

;15(3):149–51.

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

;151:141–7.

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

;9(4):220–4.

Rubin AI, Chen EH, Ratner D. Basal Cell Carcinoma. N Engl J

Med 2005;353:2262–9.

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

Augenheilkd 2000;217:207–14.

Bath-Hextall F, Bong J, Perkins W, Williams H. Interventions for

basal cell carcinoma of the skin: systematic review. BMJ

;329;705.

Walker P, Hill D. Surgical treatment of basal cell carcinomas

using standard postoperative histological assessment. Australas J

Dermatol 2006;47(1):1–12.

Published

2012-12-01

Most read articles by the same author(s)

<< < 1 2 3 4