Factors predictive of recurrence of basal cell carcinoma.

Thirty recurrent basal cell carcinomas were compared with 74 nonrecurrent basal cell carcinomas to identify clinical and histologic features predictive of recurrence. Three clinical parameters were evaluated: age, duration, and location; only location proved to be of prognostic significance. Among the histologic parameters, statistically significant differences between the recurrent and nonrecurrent groups were found in: measured distance to the resection margins, shape of cell groups, growth pattern, contour of invading edge, and degree of peripheral palisading and nuclear pleomorphism. Degree of fibrosis, cystic change, and atypical squamous change were of possible prognostic significance. There were no statistically significant differences between the two groups regarding: measured depth of invasion and diameter, degree of inflammation, actinic change, tumor necrosis, nuclear hyperchromasia, nucleoli, mitoses, amount of melanin or amyloid, and size of cell groups. Based on histologic findings, the pathologist may in many cases be able to suggest to the surgeon which tumors are more likely to recur and therefore require more aggressive therapy.