title: [Characteristics and risk factors for recurrence of cutaneous squamous cell carcinoma with conventional surgery and surgery with delayed intraoperative margin assessment].
abstract: BACKGROUND
  Non-melanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma (SCC). Basal cell carcinoma is the most common and least aggressive but in a low percentage of cases, despite appropriate wide surgical margins, it can be aggressive, producing local invasion, recurrences and distance metastasis. SCC has a more aggressive behaviour invading first the skin, the lymph nodes and less frequently produces distance metastasis OBJECTIVE: To identify the characteristics of recurrent SCC and frequency of new SCC after conventional surgical and primary closure or closure delayed until a histological reporting of tumour-free surgical margins, in order to achieve a better surgical option, in our Mexican population.
  
  
  METHODS
  We reviewed clinical records from the last 10 years, and included those with a diagnosis of SCC.
  
  
  RESULTS
  One hundred and fourteen tumours in 103 patients were included. The mean new tumour diagnosis was 32.2 per year; there were 46.6% men and 53.4% women. Age range 19-91, with mean 71.94 years (SD=13.34). The evolution time was from 1-112 months (mean=12 months, SD=2.65). The most affected site was the cheek. In addition, an invasive tumour was reported in 54% in the histopathological study. At 10-year follow-up we found a second SCC in 14 patients and only 4 recurrences, between the 1st and 4th year and 3were treated with delayed closure until margins were tumour-free.
  
  
  CONCLUSIONS
  In this study we demonstrated that delayed closure technique is easy and adaptable in our population in the treatment of SCC, achieving good results with very low recurrences at 10- year follow -up.
authors.affiliation: Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y de la Nutrición Salvador Zubirán, Ciudad de México, México. Electronic address: judom59@hotmail.com.
authors.forename: Judith
authors.initials: J
authors.lastname: Domínguez-Cherit
authors.affiliation: Servicio de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors.forename: Georgina
authors.initials: G
authors.lastname: Rodríguez-Gutiérrez
authors.affiliation: Servicio de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors.forename: Verónica
authors.initials: V
authors.lastname: Narváez Rosales
authors.affiliation: Servicio de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors.forename: Sonia
authors.initials: S
authors.lastname: Toussaint Caire
authors.affiliation: Servicio de Dermatología, Hospital General Dr. Manuel Gea González, Ciudad de México, México.
authors.forename: Verónica
authors.initials: V
authors.lastname: Fonte Avalos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009928:Organ Specificity; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D058106:Wound Closure Techniques; D055815:Young Adult
keywords: Carcinoma epidermoide; Cáncer de piel no melanoma; Modified Mohs; Mohs modificado; Non-melanoma skin cancer; Recurrence; Recurrencia; Squamous cell carcinoma