title: Surgical Treatment and Recurrence of Cutaneous Nasal Malignancies: A 26-Year Retrospective Review of 1795 Patients.
abstract: Frequent localization of facial malignancies in the nasal area and their required complete surgical extirpation pose a significant challenge to the plastic surgeon, who is called to perform a suitable delicate reconstruction of produced nasal skin defects. The present study was aimed to examine the role of tumor characteristics in the prognosis of patients with nasal skin cancer undergoing surgical management.A retrospective review of 1795 patients operated on for nasal cutaneous neoplasms during a 26-year period is presented in our study. Descriptive statistics were appropriately calculated; multivariate Cox regression analysis was performed regarding the possible risk factors for recurrence. Only those with a complete follow-up were included in the study. The mean age of our study population was 66.7 years with a male majority (52.4%). Basal cell carcinoma appeared as the most common histological type (87.7%), followed by squamous cell carcinoma (7.9%); the latter correlated with poor prognosis.The nasal sidewalls were the most frequent lesion location (29.8%), followed by the alae (27.8%), dorsum (21.7%), and tip (19.3%). The columella was very rarely affected (0.5%) but was associated with increased recurrence [hazard ratio, 4.74; 95% confidence interval (CI), 1.12-20.00; P = 0.034]. Most patients were treated with elliptical excision and direct closure (58.7%). Local flaps (31.0%) and skin grafting (9.0%) proved very reliable surgical options, especially for larger, high-risk lesions. Recurrence transpired in 46 patients (2.6%) and 4 skin cancer-related deaths occurred.Surgical modality of choice should be individualized and carefully adjusted to patients' needs. Moreover, more elective techniques, such as Mohs micrographic surgery or cumulative therapeutic approaches, like irradiation, should be examined as a beneficial aid to confront high-risk malignancies.
authors.affiliation: From the *Plastic Surgery Department, "Andreas Sygros" Hospital for Skin and Venereal Diseases, National University of Athens, Greece; †Department of Epidemiology, National University of Athens, Greece; ‡Dermatological Department, "Andreas Sygros" Hospital for Skin and Venereal Diseases, National University of Athens, Greece; and §National University of Athens, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Christopoulos
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Fotis
authors.initials: F
authors.lastname: Karantonis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karypidis
authors.forename: Grigoris
authors.initials: G
authors.lastname: Hampsas
authors.forename: Epaminondas
authors.initials: E
authors.lastname: Kostopoulos
authors.forename: Maria
authors.initials: M
authors.lastname: Kostaki
authors.forename: Othon
authors.initials: O
authors.lastname: Papadopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D016016:Proportional Hazards Models; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D013524:Surgical Flaps; D055815:Young Adult