title: Analysis of 256 cases of basal cell carcinoma after either one-step or two-step surgery in a Japanese institution.
abstract: Basal cell carcinoma (BCC) is a common skin cancer that arises from the cells of the basal layer of the epithelium or from the external root sheath of the hair follicle. In the present report, 256 cases treated surgically between 1999 and 2008 in our department were retrospectively analyzed. The most frequent BCC locations included the face (77.8%), especially the nose (26.9%) and eyelids (21.5%). Incomplete excisions occurred in 21 cases. Two patients experienced local recurrence; one of these patients exhibited a bone metastasis while the other had a metastasis of the parotid gland without the local recurrence. The rate of local BCC recurrence was 0.78%, which is lower than that described in previous reports. We categorized BCC into four histological types: superficial, solid, adenoid and infiltrative. The solid type was the most frequent histological type (62.1%). For preventive recurrence, we treated BCC patients with two-step surgery when the tumor was large or histologically invasive. At the first step, we excised the tumor with a sufficient safety margin, and at the second step, we performed reconstruction after the histological confirmation that no remnant malignant cells were in the tumor margins. In the present report, no local recurrence occurred in patients following the two-step surgery. Therefore, two-step surgery is recommended for tumors at locations and with histological types related to frequent recurrence.
authors.affiliation: Department of Anatomy, Biology and Medicine (Dermatology), Faculty of Medicine, Oita University, Yufu, Japan. gotomizu@med.oita-u.ac.jp
authors.forename: Mizuki
authors.initials: M
authors.lastname: Goto
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kai
authors.forename: Shoko
authors.initials: S
authors.lastname: Arakawa
authors.forename: Masaki
authors.initials: M
authors.lastname: Oishi
authors.forename: Kazushi
authors.initials: K
authors.lastname: Ishikawa
authors.forename: Saburou
authors.initials: S
authors.lastname: Anzai
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hatano
authors.forename: Osamu
authors.initials: O
authors.lastname: Okamoto
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Katagiri
authors.forename: Sakuhei
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Shimizu
authors.forename: Aiko
authors.initials: A
authors.lastname: Kato
authors.forename: Hiromi
authors.initials: H
authors.lastname: Shibuya
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Eshima
authors.forename: Hiroto
authors.initials: H
authors.lastname: Terashi
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery