Predicting Incomplete Basal Cell Carcinoma Excisions - a Large Multidisciplinary Retrospective Analysis in a Tertiary Center

Duarte, B; Vieira, L; Pessoa e Costa, T; Ribeiro, L; João, A; Cabete, J; Varanda Pereira, A

http://hdl.handle.net/10400.17/3981

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Abstract(s)

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.Objectives: 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 settingMethods: Retrospective cohort study of 2305 surgically treated lesions in different departments of a tertiary center.Results: There was a rate of incomplete excisions (15%) and a recurrence rate (35.5% vs. 6.8% in incomplete vs. complete excisions (p < .001)). A third of incompletely excised basal cell carcinoma (BCC) will recur over time. Stratified by relevancy, high-risk histological subtypes (micronodular (OR 5.10 - p < .001) and morpheaform (OR 5.42 - p < .001), smaller specimen sizes ( <0.5 cm or 0.5-1 cm, OR 3.99 and 2.49, respectively, p < .001) high-risk locations (OR 3.06 on the nose, OR 2.77 on the eyelids, p < .001), and recurrent BCCs (OR 1.72, p < .001). are the best predictors of an incomplete excision.Conclusions: Acknowledging the rate, recurrence risk and predictive factors for incomplete excisions may be beneficial for optimal preoperative planning and to prevent unwarranted re-interventions, morbidity, and healthcare costs.

Keywords

HSAC DER HSJ CPR Aged Female Male Humans Carcinoma, Basal Cell / mortality Carcinoma, Basal Cell / pathology Carcinoma, Basal Cell / surgery Follow-Up Studies Middle Aged Neoplasm Recurrence, Local Odds Ratio Risk Factors Retrospective Studies Skin Neoplasms / mortality Skin Neoplasms / pathology Skin Neoplasms / surgery Survival Rate Tertiary Care Centers