Surgical Treatment of Facial Basal Cell Carcinoma: Patient-Based Assessment of Clinical Outcome in a Prospective Cohort Study.
BACKGROUND
There are limited data on the esthetic, functional, and morphological outcomes of surgical treatment of facial basal cell carcinoma (BCC).


OBJECTIVE
The aim of our study was to assess the determinants of the evaluation of both the patients and the investigator of the esthetic, functional, and morphological impact of the surgical treatment of facial BCC.


METHODS
A prospective observational study evaluated 111 patients treated surgically for facial BCCs (n = 135 BCCs), using the Patient and Observer Scar Assessment Scale (POSAS), a validated and reliable scale designed for the evaluation of all types of scars by professionals and patients.


RESULTS
Scar assessment rated by the patients was very good. Skin aging was associated with a better surgical outcome as evaluated by POSAS (OR = 0.30, 95% CI: 0.09-0.98; p = 0.04). Conversely, histologically infiltrative or sclerosing BCC (OR = 2.33, 95% CI: 0.95-5.71; p = 0.06) was independently associated with poorer POSAS. In terms of the investigator's evaluation, aging signs (protective factor: OR = 0.17, 95% CI: 0.04-0.73; p = 0.01), location on the H-zone of the face (risk factor: OR = 2.95, 95% CI: 1.07-8.15; p = 0.03), and histologically infiltrative or sclerosing BCC (risk factor: OR = 2.89, 95% CI: 1.01-8.29; p = 0.04) were independently associated with POSAS.


CONCLUSIONS
Esthetic, functional, and morphological outcomes of facial BCC surgery provide high patient satisfaction overall. Taking wider margins requires specific measures to improve the surgical outcome.
Department of Dermatology, Paul Sabatier University and Toulouse University Cancer Institute, Toulouse, France.
Joséphine
J
Ofaiche
Raphael
R
Lopez
Emilie
E
Bérard
Aymeric
A
André
Cristina
C
Bulai-Livideanu
Thomas
T
Méresse
Benjamin B
BB
Vairel
Jean-Louis
JL
Grolleau
Carle
C
Paul
Nicolas
N
Meyer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology* / Q000473:pathology; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D004954:Esthetics; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D015595:Skin Aging; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome