Staged-surgery with permanent pathology for the management of high-risk nonmelanoma skin cancer of the nose.

The objective of the study was to investigate the effect of staged-surgery with permanent pathology on tumour recurrence of high-risk nonmelanoma skin cancers (NMSCs) of the nose and to determine the factors associated with subclinical spread and deep-margin involvement. Twenty-one patients who underwent staged-surgery with permanent pathology for high-risk NMSCs of the nose between 2007 and 2008 were prospectively followed-up for tumour recurrence. The incidence of tumour recurrence after staged-surgery with permanent pathology was 0%. A positive correlation between perineural involvement and subclinical spread (p = .012); and a statistically significant relationship between infiltrative type basal cell carcinoma (BCC) and deep-margin involvement (p = .033) was detected. Staged-surgery with permanent pathology is a reliable surgical method for complete excision of high-risk NMSCs of the nose and provides a significant decrease in tumour recurrence. Perineural involvement may cause subclinical spread, and infiltrative type BCC may invade deeper structures of the nose.