Margin positive basal cell carcinoma – 10 years retrospective analysis
Journal Title: Medpulse International Journal of Surgery - Year 2019, Vol 9, Issue 1
Abstract
Background: Basal cell carcinoma (BCC) is a locally invasive malignant tumor. Incidence is increasing by 10% per year; incidence of metastases is minimal, but local recurrence is common. The complete excision of the BCC allows reduction of relapse. Materials and Methods: Retrospective data was collected from hospital data base of the patients who were diagnosed to have BCC and underwent surgery during period of January 2006 to December 2015. The patient and tumor character’ son age, primary site of tumor, tumor size, surgery and reconstruction done, pathologic diagnosis, marginal status, adjuvant therapy, recurrence and disease status at last follow-up were noted. Results: Total of 73 patients were treated during study period. All patients underwent wide local excision. Three patients underwent orbital exentration, who had tumor around eye and was infiltrating conjunctiva/cornea. Margins were focally positive in 19 patients. These patients were not submitted for reexcision and were on follow up. Margins were free in 54 patients with average margin of 2.1 mm (range 1 mm –5 mm). Four patients received adjuvant radiation as one patient had twice recurrence, two patients had gross positive margin and other patient had perineural invasion. At a median follow up of 27 months (range, 1 to 71 months), 46 patients are on follow up. Five (10.9%) patients had recurrence. Four of five patients had focally positive margin on histopathology at initial surgery, one patient had free margin of 2mm during initial surgery. Reexcision was done in all patients with advant radiation therapy in one patient who presented with twice recurrence. Twenty seven patients were lost to follow up. Of 19 patients, histopathology report showing focally positive margins, four (21 %) patients recurred at a median follow up of 22.6 months (range, 12 – 36 months). Conclusion: Basal cell carcinoma is locally invasive malignant tumor with indolent course. Wide excision with adequate margin is the treatment of choice. Even with focally positive microscopic margin, chance of recurrence is around 23% on long term follow up, and should be managed surgically when detected, in centers where frozen section is not routinely practiced.
Authors and Affiliations
Siddappa K Thammaiah, Santosh Ijeri
Keywords
Related Articles
- EP ID EP471565
- DOI 10.26611/106917
- Views 163
- Downloads 0
A study of inguinalhernia repair of at tertiary health care center with respect to non-fixation orfixation of mesh inextra peritoneum
Background: Hernia is derived from a latin word meaning “a rupture”. Abdominal wall hernias are frequently encountered in surgical practice accounting for 15% - 18% of all surgical procedures Aims and Objectives:To study...
Evaluation of pre and post operative status of hepatic and renal function conditions in open cholecystectomy patients
Background: Cholecystectomy is one of the most commonly performed abdominal surgical procedures. For the last 150 years, morbidity and mortality for surgical procedures have been accepted as unavoidable parts of the ther...
Comparison of sentinel lymph node biopsy versus four node sampling for management of carcinoma breast
Background: Breast cancer is the leading malignancy, and the second leading cause of cancer related deaths. It is well established that axillary lymph node status is a very important prognostic factor in breast cancer pa...
A study of different modalities in treatment of lower limb varicose veins
Background: Varicose veins and their associated symptoms and complications constitute chronic vascular disorders leading to surgical treatment. In developing countries like India, study encompassing the clinical evaluati...
A comprehensive evaluation of fistula in ano in Maharashtra population
Fistula in Ano is a non-malignant treatable lesion of the rectum and the anal canal. Cryptoglandular infection accounts for approx. 90% of these cases. Majority of the infections are acute and few cases contributed by ch...