[Malignant facial tumors. Ambulatory therapy and new methods of cancer prevention].
BACKGROUND
The growth rate of malignant facial skin tumors is one of the highest of all malignancies. The predominantly older patients mostly wish outpatient treatment. The aim of the study was to describe the strategy and results of outpatient tumor surgery. Based on two representative surveys, another objective was to establish whether it is useful to involve dentists in early cancer diagnosis.


METHODS
The retrospective case analysis comprised 77 patients (average age 67.8 years) in a private maxillofacial practice with a total of 100 malignant skin tumors. All patients were operated by the same surgeon. A frozen section analysis was carried out in 75 patients. Two surveys including 2500 participants each were conducted to determine the frequency of consultations with dermatologists for skin cancer checkup and the incidence of doctor-patient contacts among different specialists in the past 12 months.


RESULTS
A total of 96% of the patients could be operated "in sano" in a one-stage procedure. Of these patients, 50% needed further intraoperative resections based on the frozen section analysis. Of the excisional defects, 71% could be closed by local flaps and 24% by skin grafting. Follow-up examinations after a mean of 34.6 months revealed one local recurrence. The surveys showed that only 17.4% of the interviewees contacted the general practitioner at least once every 2 years while 61.1% of those surveyed never had their skin examined. In the last 12 months, general practitioners were the most frequently consulted doctors (67.6% of the interviewees), followed by dentists in second place (44.1%). Other specialists were less frequently consulted.


CONCLUSIONS
One-stage outpatient treatment of malignant facial skin tumors in combination with frozen section analysis is a reliable and practicable method. After attending medical continuation courses, dentists should play a more active role in the prevention of skin cancer because of their frequent doctor-patient contacts.
Halling
F
F
Praxis für MKG-Chirurgie/Plastische Operationen, Leipziger Strasse 130, 36037 Fulda. Dr.Halling@T-online.de
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D002280:Basal Cell Carcinoma / Q000517:prevention & control / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000517:prevention & control / Q000601:surgery; D005153:Facial Neoplasms / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D013524:Surgical Flaps