Facial basal cell carcinoma: analysis of recurrence and follow-up strategies.

Rates of recurrence after incomplete surgical excision of basal cell carcinoma (BCC) range from 4 to 16.6% of analyzed cases. The aim of the present study was to identify the predictive factors associated with facial BBC recurrence following excision and their influences, in order to establish a proper therapeutic strategy. A monocentric retrospective study was performed reviewing all BCCs surgically excised at the Institute of Plastic Surgery, University of Padua, with particular focus on the involvement of surgical margins and recurrence. Seven hundred and nineteen lesions in 605 patients were studied. Correlations between recurrence probability and various characteristics of BCC were analyzed using a logistic regression model. It was observed that incomplete excision, deep margin involvement, the presence of sclerodermiform or metatypic basaloid squamous cells, as well as pleomorphous histological variants and/or peritumoral inflammatory infiltrates, were all related to an increase in the probability of recurrence. BCC excision must be followed by individualized management with particular consideration for the localization, the histological type and other known predisposing factors; the treatment strategy and, in particular, the length of the surveillance period and the frequency of patient assessment should be evaluated on the basis of the recurrence probability outlined.