title: Meta-analysis of published data on incompletely excised basal cell carcinomas of the ear and nose with introduction of an innovative treatment strategy.
abstract: BACKGROUND
  Auricular/nasal basal cell carcinomas (BCC) often require more surgical procedures than BCCs at other sites.
  
  
  METHODS
  A meta-analysis of incompletely excised BCCs compares those on the ear and nose to other sites. The combination of photodynamic diagnostics (PDD) and fresh-frozen sections is compared to multi-stage excisions; in each case, the tissue margins were histographically controlled.
  
  
  RESULTS
  The relative risk of an incomplete excision of a BCC on the ear/nose is 2.5 fold higher than on the rest of the body. The combination of PDD and micrographic surgery with fresh-frozen sections reduces the length of stay by 42.86 % from median 14 d to 8 d as well as increasing the revenue per patient per day by 41.9 % from 320.61 euro to 454.95 euro with nearly a comparable rate of recurrences after one year.
  
  
  CONCLUSIONS
  PDD in combination with single-stage surgery is an equivalent therapy with few side effects and conforming to guidelines. It takes into account both quality assurance and patient preferences. Multicenter, randomized trials seem desirable.
authors.affiliation: Department of Dermatology, Venereology and Allergy, University of Leipzig, Germany. christina.rogalski@medizin.uni-leipzig.de
authors.forename: Christina
authors.initials: C
authors.lastname: Rogalski
authors.forename: Friederike
authors.initials: F
authors.lastname: Kauer
authors.forename: Jan Christoph
authors.initials: JC
authors.lastname: Simon
authors.forename: Uwe
authors.initials: U
authors.lastname: Paasch
mesh_terms: D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000628:therapy*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D006801:Humans; D015580:Mohs Surgery / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010506:Periodicals as Topic / Q000706:statistics & numerical data; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome