Audit of histologically incompletely excised basal cell carcinomas: recommendations for management by re-excision.
In an audit of 1392 basal cell carcinomas arising in 1165 patients, excised under the care of one consultant in the 10 years from 1988 to 1997, 99 (7%) were reported histologically as incompletely excised. Lateral margins alone were involved in 54 (55%), deep margins in 36 (36%) and both in 9 (9%). Although the policy throughout this period was to re-excise all such lesions, 74/99 (75%) were re-excised (compared with an average re-excision rate of 30% through other published series). For those patients undergoing re-excision, residual tumour was reported histologically in 40/74 (54%). Peri-orbital lesions showed an overall incomplete excision rate of 13% (range 11-17%); however, only 4/16 of re-excisions in this area revealed residual tumour. Many clinicians have traditionally observed patients with incompletely excised basal cell carcinomas. The present study reports the largest series of re-excisions after incomplete excision of basal cell carcinoma, and has revealed that on the balance of probability such re-excisions will reveal residual tumour. Re-excision appears the appropriate course in almost all the anatomical areas studied although, with the exception of the inner canthus, periorbital lesions will have a low probability of residual tumour being identified.
Griffiths
R W
RW
Northern General Hospital, Sheffield, UK.
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D002648:Child; D004739:England; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D018365:Neoplasm, Residual; D012086:Reoperation; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*