title: Treatment of Pigmented Basal Cell Carcinoma with 3 mm Surgical Margin in Asians.
abstract: Background. In Asians, most basal cell carcinomas (BCCs) are pigmented with clear borders. The consensus of 4 mm surgical margin for BCC largely depends on studies in nonpigmented BCCs in Caucasians. However, little is known about recurrences of pigmented BCCs with a narrower surgical margin. We aimed to investigate 5-year recurrence of BCCs, either pigmented or nonpigmented, in Taiwanese with 3 mm surgical margin. Materials and Methods. 143 patients with BCC (M/F = 66/77, average 64 years) were confirmed pathologically from 2002 to 2013. Based on the pathological margin (>1 mm, ≤1 mm, and involved), patients were categorized into the complete excision group (n = 77), histology with close proximity group (n = 43), and unclear surgical margin group (n = 23). Results. Among 143 cases, 105 were pigmented. With standard 3 mm excision, there were 7 recurrences, with 6 of them from nonpigmented BCC group. Logistic regression showed that pigmentation was associated with lower recurrence. Interestingly, 5-year recurrence of completely excised and histology with close proximity BCC (0/77 versus 1/43) was not different statistically. Conclusions. A 3 mm surgical margin is adequate for pigmented BCC. A "wait and see" approach rather than further wide excision is appropriate for BCC with <1 mm free margin.
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shang-Hung
authors.identifier: 0000-0002-7069-6993
authors.initials: SH
authors.lastname: Lin
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yu-Wen
authors.initials: YW
authors.lastname: Cheng
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yi-Chien
authors.identifier: 0000-0002-2039-8998
authors.initials: YC
authors.lastname: Yang
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ji-Chen
authors.initials: JC
authors.lastname: Ho
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chih-Hung
authors.identifier: 0000-0001-9804-3874
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D002280:Basal Cell Carcinoma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery