Do basal cell carcinomas recur after complete conventional surgical excision?
Section snippets
Material and methods
The data base of consecutive patients having basal cell carcinomas excised under the care of one consultant for the 11 years from 1988 to 1998 was studied. The total number of patients and total number of lesions were noted. All first lesions treated in the period were designated index lesions. Second lesions identified either in the 1988–1998 period or subsequent 5 years 1999–2003 were studied to determine if they could reasonably be considered from their position, to represent possible or
Results
In the period 1988–1998 (11 years) 1378 patients (median age 70 years) were treated with conventional surgical excision for 1635 first index basal cell carcinomas. One hundred and nineteen (7%) were reported as incompletely excised and the policy was to re-excise these. In practice 91/119 (76%) were re-excised with residual tumour found in 48/91 (53%).
Discussion
Despite the theoretical advantage of more extensive histological assessment of excision margins for BCC with Mohs' micrographic surgery, the 5 years recurrence rates for BCC after complete excision by either Mohs' surgery or conventional surgery are similar in the range 0.35–2.6%.1, 2, 3, 4, 5, 13, 14 These publications contain little information on the nature or definition of the local recurrences, however. Specifically, local recurrence is not consistently or uniformly defined, nor are index
Acknowledgements
We are delighted to thank Robert Salthouse for his hard work in preparing the colour illustrations to such a high standard.
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