High recurrence rates of Basal cell carcinoma after mohs surgery in patients with chronic lymphocytic leukemia.
OBJECTIVE
To estimate and compare the recurrence rates of basal cell carcinoma (BCC) after Mohs surgery in patients with chronic lymphocytic leukemia (CLL) and controls and to evaluate differences among histologic subtypes of BCC.


METHODS
Retrospective assessment of clinical histories, postoperative notes, and surgical photographs.


METHODS
Tertiary-care institution (Mayo Clinic, Rochester, Minn).


METHODS
Twenty-four patients with CLL who underwent Mohs surgery for 33 BCCs and 66 controls matched for sex, age, and surgical year who underwent Mohs surgery for BCC of the head and neck from May 1988 through September 1998.


RESULTS
Among the 24 patients with CLL who underwent Mohs surgery for 33 BCCs, there were 4 recurrences. The cumulative incidence of recurrence on a per-tumor basis was 3% at 1 year, 12% at 3 years, and 22% at 5 years. Basal cell carcinoma was 14 times more likely to recur in patients with CLL than in controls (P =.02). Overall, there were no significant differences between patients with CLL and controls in preoperative tumor size (median, 1.6 cm vs 1.4 cm; P =.18) and proportion of aggressive histologic subtypes of BCC (58% vs 41%; P =.12).


CONCLUSIONS
Recurrence rates of BCC are significantly higher after Mohs surgery in patients with CLL. Overall, patients with CLL do not appear to have significantly larger BCCs or more aggressive histologic subtypes of BCC. In patients with CLL, close surveillance is warranted for recurrence of BCC and a decreased threshold is indicated for subsequent biopsies.
Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
Khosrow
K
Mehrany
Roger H
RH
Weenig
Mark R
MR
Pittelkow
Randall K
RK
Roenigk
Clark C
CC
Otley
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006257:Head; D006801:Humans; D015994:Incidence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015580:Mohs Surgery; D009333:Neck; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery