대한두개안면성형외과학회지 (Archives of Craniofacial Surgery)

  • 제22권3호
  • /
  • Pages.135-140
  • /
  • 2021
  • /
  • 2287-1152(pISSN)
  • /
  • 2287-5603(eISSN)
대한두개안면성형외과학회 (Korean Cleft Palate-Craniofacial Association)
권호 표지
DOI QR코드

DOI QR Code

Does reduction of the oncologic safety margin for facial basal cell carcinoma result in higher recurrence rates?

  • Kim, Eon Su (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Yang, Chae Eun (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Chung, Yoon Kyu (Department of Plastic and Reconstructive Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine)
  • 투고 : 2021.05.20
  • 심사 : 2021.06.10
  • 발행 : 2021.06.20
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions' cancer recurrence rate and safety on the facial region with new safety margins. Methods: We included patients with primary BCC on the facial region who underwent wide excision with 2- or 3-mm safety margins at our institution between January 2010 and December 2018. Medical records were reviewed to confirm the epidemiology and surgical information. Recurrence was confirmed by physical examination through regular 6-month follow-up. Results: We included 184 out of 233 patients in this study after applying the exclusion criteria. The mean age and follow-up period were 71.2±10.2 years and 29.3±13.5 months, respectively. The predominantly affected area was the nose (95 cases); a V-Y advancement flap was the most commonly used surgical method. There were two cases of recurrence in the 2 mm margin group and one recurrence in the group resected with 3 mm margins. Conclusion: In this large cohort study, we found 2-3 mm excision margins can yield enough safety in facial BCCs. The recurrence rates were found to be comparable with those reported after wider margins.

키워드

참고문헌

  1. Chren MM, Linos E, Torres JS, Stuart SE, Parvataneni R, Boscardin WJ. Tumor recurrence 5 years after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma. J Invest Dermatol 2013;133:1188-96. https://doi.org/10.1038/jid.2012.403
  2. Mendez BM, Thornton JF. Current basal and squamous cell skin cancer management. Plast Reconstr Surg 2018;142:373e-387e. https://doi.org/10.1097/PRS.0000000000004696
  3. Mohan SV, Chang AL. Advanced basal cell carcinoma: epidemiology and therapeutic innovations. Curr Dermatol Rep 2014;3:40-5. https://doi.org/10.1007/s13671-014-0069-y
  4. Dacosta Byfield S, Chen D, Yim YM, Reyes C. Age distribution of patients with advanced non-melanoma skin cancer in the United States. Arch Dermatol Res 2013;305:845-50. https://doi.org/10.1007/s00403-013-1357-2
  5. American Cancer Society. Cancer Facts & Figures 2020 [Internet]. Atlanta, GA: American Cancer Society; c2020 [cited 2021 Jan 16]. Available from: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2020.html.
  6. Park YJ, Kwon GH, Kim JO, Kim NK, Ryu WS, Lee KS. A retrospective study of changes in skin cancer characteristics over 11 years. Arch Craniofac Surg 2020;21:87-91. https://doi.org/10.7181/acfs.2020.00024
  7. Walling HW, Fosko SW, Geraminejad PA, Whitaker DC, Arpey CJ. Aggressive basal cell carcinoma: presentation, pathogenesis, and management. Cancer Metastasis Rev 2004;23:389-402. https://doi.org/10.1023/B:CANC.0000031775.04618.30
  8. Breuninger H, Dietz K. Prediction of subclinical tumor infiltration in basal cell carcinoma. J Dermatol Surg Oncol 1991; 17:574-8. https://doi.org/10.1111/j.1524-4725.1991.tb03655.x
  9. Gulleth Y, Goldberg N, Silverman RP, Gastman BR. What is the best surgical margin for a Basal cell carcinoma: a meta-analysis of the literature. Plast Reconstr Surg 2010;126:1222-31. https://doi.org/10.1097/PRS.0b013e3181ea450d
  10. Marzuka AG, Book SE. Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. Yale J Biol Med 2015;88:167-79.
  11. Wolf DJ, Zitelli JA. Surgical margins for basal cell carcinoma. Arch Dermatol 1987;123:340-4. https://doi.org/10.1001/archderm.1987.01660270078019
  12. Bichakjian CK, Olencki T, Aasi SZ, Alam M, Andersen JS, Berg D, et al. Basal cell skin cancer, version 1. 2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2016;14:574-97. https://doi.org/10.6004/jnccn.2016.0065
  13. Thomas DJ, King AR, Peat BG. Excision margins for nonmelanotic skin cancer. Plast Reconstr Surg 2003;112:57-63. https://doi.org/10.1097/01.PRS.0000067479.77859.31
  14. Wee SJ, Park MC, Chung CM. Basal cell carcinoma misdiagnosed as trichoepithelioma. Arch Craniofac Surg 2020;21:202-5. https://doi.org/10.7181/acfs.2020.00157
  15. Wong CS, Strange RC, Lear JT. Basal cell carcinoma. BMJ 2003;327:794-8. https://doi.org/10.1136/bmj.327.7418.794
  16. Cameron MC, Lee E, Hibler BP, Giordano CN, Barker CA, Mori S, et al. Basal cell carcinoma: contemporary approaches to diagnosis, treatment, and prevention. J Am Acad Dermatol 2019;80:321-39. https://doi.org/10.1016/j.jaad.2018.02.083
  17. Shelton ME, Adamson AS. Review and update on evidence-based surgical treatment recommendations for nonmelanoma skin cancer. Dermatol Clin 2019;37:425-33. https://doi.org/10.1016/j.det.2019.05.002
  18. Walker P, Hill D. Surgical treatment of basal cell carcinomas using standard postoperative histological assessment. Australas J Dermatol 2006;47:1-12. https://doi.org/10.1111/j.1440-0960.2006.00216.x
  19. Nicoletti G, Brenta F, Malovini A, Musumarra G, Scevola S, Faga A. Study to determine whether intraoperative frozen section biopsy improves surgical treatment of non-melanoma skin cancer. Mol Clin Oncol 2013;1:390-4. https://doi.org/10.3892/mco.2012.51
  20. Cumberland L, Dana A, Liegeois N. Mohs micrographic surgery for the management of nonmelanoma skin cancers. Facial Plast Surg Clin North Am 2009;17:325-35. https://doi.org/10.1016/j.fsc.2009.06.001

피인용 문헌

  1. Surgical refinement of the purse-string suture for skin and soft tissue defects of the head and neck vol.22, pp.4, 2021, https://doi.org/10.7181/acfs.2021.00297