The prognosis of incompletely excised basal cell carcinomas

Reported recurrence rates for incompletely excised basal cell carcinoma(BCC) vary widely (30-67%), and the destructive potential of recurrent BCC iswell known. When surgically treated BCC are reported as incompletely excised bythe pathologist, the surgeon encounters the dilemma as whether to perform animmediate wider excision, or to reserve further treatment until there is clinicalevidence of recurrence. The aim of the present study is to determine whetherthere are any clinical or morphological features which may enlighten themanagement of this adversity.The pathology and plastic surgery databases of Celal Bayar UniversityHospital were reviewed retrospectively. During the period of 1995-2005, 369BCC lesions were reported as resected where 71 of them being reported asincopletely excised. The management and recurrence rates of the incompletelyexcised BCC were derived from patient records and follow up by phone wasresorted when necessary. The clinical and morphological features werecorrelated with the recurrence rates in order to develope a management strategy.Incomplete excisions were much higher in women with the age under 45years, nearly located at the nasal and periorbital area and the subgroup beinginfiltrative. Twelve of the patients with incompletely excision (16.90%) were re-excised. All re-excisions were made within 2 months postoperatively. There wereonly 2 pathological specimens with BCC. The other 59 patients were follow-up.The overall recurrence rate was 9.2 %. Median time for recurrence was 43.20months (range 12-132 months).Womans, patients under 45 years, the lateral and deep margin ofincompletely excision, infiltrative subtype, the neck and chin region havediscernible effect on recurrence rates.Observation is an acceptable management option in most situaitons insuch a manner that only 16.90 % of the incompletely excised lesions acquiredfurther treatment. Most recurrences occured in early future neverthelessmeticulous follow up of those patients is required for at least 10 years.Keywords: Carcinoma Basal Cell, Recurrence, Excision, Retreatment