title: Cosmetic results of histographically controlled excision of non-melanoma skin cancer in the head and neck region.
abstract: BACKGROUND
  Beside the primary goal of complete eradication, the cosmetic result is an important aspect of the treatment of non-melanoma skin tumors especially in the head and neck region.
  
  
  METHODS
  From 1990 to 2000, we treated a total of 5,227 large basal cell carcinomas (BBC) and 1,189 squamous cell carcinomas (SCC) in the head and neck region by surgical excision in 4,239 inpatients at the Department of Dermatology, University of Tübingen. The procedure used in all patients was a conservative excision controlled by complete three dimensional histology of all margins (3D-histology) and specifically targeted follow-up surgery where required (histographic surgery). As part of the prospective tumor follow-up, we asked the treating outdoor physician one and four years later to evaluate the results of our surgical procedures.
  
  
  RESULTS
  Of the 5,565 follow-up questionnaires sent back, 4,868 contained answers regarding the cosmetic result. The data from both answers were pooled. In 1,972 (40,5 %) patients the cosmetic result was evaluated as "excellent", in 1,992 (40,9%) as "good", in 662 (13,6%) as "satisfactory", in 191 (3,9%) as "mediocre" and in 51 (< 1,0%) as "poor". In 697 of the responses, the physician did not comment the cosmetic results or the patient was lost for follow up.
  
  
  CONCLUSIONS
  With respect to both long term safety and cosmetic outcome, tumor surgery with 3D-histology of excisional margins has set very high quality standards in the treatment of non-melanoma skin cancer of the head and neck area.
authors.affiliation: Department of Dermatology, Universitäts-Klinikum Tübingen, Germany.
authors.forename: Franziska Carola
authors.initials: FC
authors.lastname: Eberle
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schippert
authors.forename: Birgit
authors.initials: B
authors.lastname: Trilling
authors.forename: Martin
authors.initials: M
authors.lastname: Röcken
authors.forename: Helmut
authors.initials: H
authors.lastname: Breuninger
mesh_terms: D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D015580:Mohs Surgery / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D013518:Surgery, Plastic / Q000706:statistics & numerical data*; D016896:Treatment Outcome