Linus T D Armstrong1, Mark R Magnusson2, Michelle P B Guppy1. 1. University of New England, School of Rural Medicine, Armidale, NSW, Australia. 2. Toowoomba Plastic Surgery, Toowoomba, QLD, Australia. Electronic address: mark@toowoombaplasticsurgery.com.au.
Abstract
BACKGROUND: Several tumour features and surgical factors have been implicated in an increased risk of BCC recurrence after excision; however, there are limited data on facial lesions specifically. This study sought to evaluate risk factors of facial BCC, which may influence future treatment and follow-up regimes. METHODS: Facial BCCs excised from a single surgeon practice over a 2-year period were included in the study. Data pertaining to patient demographics, lesion depth of invasion, surface area, excision margins, perineural infiltration, location, previous history of recurrence, histological subtype and ulceration were extracted. A search of recurrence was conducted over the following 70-80 months. RESULTS: In total, 331 cases of facial BCC were included, and 10 lesions recurrences (3%) were identified within the observation period. Infiltrative (p = 0.02) and micronodular (p = 0.04) subtypes as well as incomplete or close (within 1 mm) peripheral (p = 0.01) and deep excision margins (p = 0.04) were significantly associated with tumour recurrence. Five of the 10 recurrent lesions had been re-excised for a recurrence previously, placing them at much greater risk of future recurrence (p = 0.00). CONCLUSIONS: Incomplete and close excision margins, infiltrative and micronodular subtypes and previous excision are strong risk factors for facial BCC recurrence. Although depth of invasion, perineural infiltration, ulceration and surface area may indicate the aggressive nature of a lesion, the results suggest that with adequate excision margins, these factors may not influence the recurrence rate. The strongest risk factor was a lesion having already recurred after previous excision, and it suggested that these lesions be treated with particular caution and a closer follow-up regime be employed.
BACKGROUND: Several tumour features and surgical factors have been implicated in an increased risk of BCC recurrence after excision; however, there are limited data on facial lesions specifically. This study sought to evaluate risk factors of facial BCC, which may influence future treatment and follow-up regimes. METHODS: Facial BCCs excised from a single surgeon practice over a 2-year period were included in the study. Data pertaining to patient demographics, lesion depth of invasion, surface area, excision margins, perineural infiltration, location, previous history of recurrence, histological subtype and ulceration were extracted. A search of recurrence was conducted over the following 70-80 months. RESULTS: In total, 331 cases of facial BCC were included, and 10 lesions recurrences (3%) were identified within the observation period. Infiltrative (p = 0.02) and micronodular (p = 0.04) subtypes as well as incomplete or close (within 1 mm) peripheral (p = 0.01) and deep excision margins (p = 0.04) were significantly associated with tumour recurrence. Five of the 10 recurrent lesions had been re-excised for a recurrence previously, placing them at much greater risk of future recurrence (p = 0.00). CONCLUSIONS: Incomplete and close excision margins, infiltrative and micronodular subtypes and previous excision are strong risk factors for facial BCC recurrence. Although depth of invasion, perineural infiltration, ulceration and surface area may indicate the aggressive nature of a lesion, the results suggest that with adequate excision margins, these factors may not influence the recurrence rate. The strongest risk factor was a lesion having already recurred after previous excision, and it suggested that these lesions be treated with particular caution and a closer follow-up regime be employed.
Authors: Marco Marcasciano; Marco Mazzocchi; Juste Kaciulyte; Noemi Spissu; Donato Casella; Diego Ribuffo; Luca Andrea Dessy Journal: Int Wound J Date: 2018-06-04 Impact factor: 3.315
Authors: Alanna C Bridgman; Christina Fitzmaurice; Robert P Dellavalle; Chante Karimkhani Aksut; Ayman Grada; Mohsen Naghavi; Navid Manafi; Andrew T Olagunju; Tinuke O Olagunju; Ranjani Somayaji; Aaron M Drucker Journal: J Cutan Med Surg Date: 2020-01-29 Impact factor: 2.092
Authors: Riccardo Pampena; Gabriele Parisi; Mattia Benati; Stefania Borsari; Michela Lai; Giovanni Paolino; Anna Maria Cesinaro; Silvana Ciardo; Francesca Farnetani; Sara Bassoli; Giuseppe Argenziano; Giovanni Pellacani; Caterina Longo Journal: Front Oncol Date: 2021-02-19 Impact factor: 6.244
Authors: Cătălin Gheorghe Bejinariu; Siramona Popescu; Christiana Diana Maria Dragosloveanu; Silviu Adrian Marinescu Journal: Rom J Ophthalmol Date: 2020 Oct-Dec
Authors: Abdulkarim Hasan; Ahmed Rabie; Mohammed Elhussiny; Mohamed Nasr; Mohamed I Kamel; Ahmed Hegab; Abdelrahman S El-Kady; Mahmoud E Nagaty; Abdelhafez Seleem; Mohammed Abbas; Abd Al-Kareem Elias; Gamal G Shemy; Ahmed Abu Elsoud; Asmaa A Dahy; Ayman Abdulmohaymen; Ahmed Youssef; Ayman Abdelmaksoud Journal: Ann Med Surg (Lond) Date: 2022-05-26