Background: Only a few prospective studies have been published on surgical treatments for cutaneous basal cell carcinoma (BCC). Objective: Our purpose was to report the clinical findings of all patients with BCC treat...Background: Only a few prospective studies have been published on surgical treatments for cutaneous basal cell carcinoma (BCC). Objective: Our purpose was to report the clinical findings of all patients with BCC treated with Mohs micrographic surgery (MMS) in Australia between 1993 and 2002. Method: This prospective,multicenter case series included all patients in Australia treated with MMS for BCC, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. The main outcome measures were patient demographics, reason for referral, duration of tumor, site, preoperative tumor size, recurrences before MMS, histologic classification of malignancy, and postoperative defect size. Results: The study included 11,127 patients (47% females and 53% males) with a mean age of 62 years (range, 15- 98 years). In 43.8% of cases BCC was a recurrent tumor. Most of the tumors (98.3% ) were on the head and neck area, most commonly on the nose (39% ), cheek and maxilla (16.5% ), periocular area (12.7% ), and auricular region (11.4% ). The most common histologic subtypes were infiltrating (30.7% ), nodulocystic (24.2% ), and superficial (13.6% ). Previously recurrent tumors were larger than primary tumors (P < .001), had a larger postexcision defect and more subclinical extension, and required more levels of excision (P < .001). Limitations: Data were missing for some outcome measures. Conclusion: This large prospective series of BCC managed by MMS is characterized by a high percentage of high- risk tumors. Most tumors were located in the mid- facial area and the histologic subtype was mainly infiltrating or nodulocystic. That previously recurrent tumors were larger and demonstrated a more extensive subclinical extension compared with primary tumors emphasizes the importance of initial tumor eradication with margin control.展开更多
Background: Long- term follow- up is essential to evaluate the role of Mohs micrographic surgery (MMS) in the treatment for cutaneous basal cell carcinoma (BCC). Objective: Our purpose was to report the 5- year follow...Background: Long- term follow- up is essential to evaluate the role of Mohs micrographic surgery (MMS) in the treatment for cutaneous basal cell carcinoma (BCC). Objective: Our purpose was to report the 5- year follow- up outcome of patients treated with MMS for BCC. Method: This prospective, multicenter case series included all patients in Australia treated with MMS for BCC, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. Parameters recorded were patient demographics, duration of tumor, site, preoperative tumor size, recurrences before MMS, histologic classification of malignancy, postoperative defect size, and 5- year recurrence after MMS. Results: Three thousand three hundred seventy (3370)- patients (1594 female and 1776 male patients) completed a 5- year follow- up period. Fifty- six percent of the tumors were primary and 44% were previously recurrent. Most of them (98.4% ) were located on the head and neck, and the most common histologic subtypes were nodulocystic (29.3% ) and infiltrating (28.3% ). Recurrence at 5 years was diagnosed in 1.4% of primary and in 4% of recurrent tumors. Previous tumor recurrence (P < .001), longer tumor duration before MMS (P=.015), infiltrating histology (P=.13), and more levels for tumor (P < .001)were the main predictors for tumor recurrence after MMS. Limitation: Data were missing for some outcome measures. Conclusion: The low 5- year recurrence rate of BCC with MMS emphasizes the importance of margin- controlled excision.展开更多
Background: Perineural invasion (PNI) is an important factor may possibly influence the aggressiveness of basal cell carcinoma (BCC). Objective: Our purpose was to evaluate the incidence, features, and outcomes of BCC...Background: Perineural invasion (PNI) is an important factor may possibly influence the aggressiveness of basal cell carcinoma (BCC). Objective: Our purpose was to evaluate the incidence, features, and outcomes of BCC with PNI in patients treated with Mohs micrographic surgery (MMS). Method: This prospective, multicenter case series included all patients in Australia treated with MMS for BCC with PNI, who were monitored by the Skin and Cancer Foundation Australia between 1993 and 2002. The parameters recorded were patient demographics, reason for referral, duration of tumor, site, preoperative tumor size, recurrence before MMS, histologic subtypes, postoperative defect size, and recurrence at 5 years after MMS. Results: Two- hundred eighty- three patients were diagnosed with PNI. Most cases occurred in male patients (61% ; P=.006) and in previously recurrent tumors (60.4% ; P < .001). The infiltrating, morpheic, and basosquamous subtypes were more likely to be associated with PNI (P < .0001). Tumor sizes before excision and postoperative defect sizes were significantly larger in cases with PNI compared with cases with no PNI (P < .001 for both parameters), as was the mean number of Mohs excision levels. Seventy- eight patients completed a 5- year follow- up period after MMS, and 6 of them (7.7% ) were diagnosed with recurrence.Limitations: Data were missing for some outcome measures. Conclusion: PNI is an uncommon feature of BCC. When present, PNI is associated with larger, more aggressive tumors, and the risk of 5- year recurrence is higher. This emphasizes the importance of tumor excision with margin control and long- term patient monitoring.展开更多
文摘Background: Only a few prospective studies have been published on surgical treatments for cutaneous basal cell carcinoma (BCC). Objective: Our purpose was to report the clinical findings of all patients with BCC treated with Mohs micrographic surgery (MMS) in Australia between 1993 and 2002. Method: This prospective,multicenter case series included all patients in Australia treated with MMS for BCC, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. The main outcome measures were patient demographics, reason for referral, duration of tumor, site, preoperative tumor size, recurrences before MMS, histologic classification of malignancy, and postoperative defect size. Results: The study included 11,127 patients (47% females and 53% males) with a mean age of 62 years (range, 15- 98 years). In 43.8% of cases BCC was a recurrent tumor. Most of the tumors (98.3% ) were on the head and neck area, most commonly on the nose (39% ), cheek and maxilla (16.5% ), periocular area (12.7% ), and auricular region (11.4% ). The most common histologic subtypes were infiltrating (30.7% ), nodulocystic (24.2% ), and superficial (13.6% ). Previously recurrent tumors were larger than primary tumors (P < .001), had a larger postexcision defect and more subclinical extension, and required more levels of excision (P < .001). Limitations: Data were missing for some outcome measures. Conclusion: This large prospective series of BCC managed by MMS is characterized by a high percentage of high- risk tumors. Most tumors were located in the mid- facial area and the histologic subtype was mainly infiltrating or nodulocystic. That previously recurrent tumors were larger and demonstrated a more extensive subclinical extension compared with primary tumors emphasizes the importance of initial tumor eradication with margin control.
文摘Background: Long- term follow- up is essential to evaluate the role of Mohs micrographic surgery (MMS) in the treatment for cutaneous basal cell carcinoma (BCC). Objective: Our purpose was to report the 5- year follow- up outcome of patients treated with MMS for BCC. Method: This prospective, multicenter case series included all patients in Australia treated with MMS for BCC, who were monitored by the Skin and Cancer Foundation between 1993 and 2002. Parameters recorded were patient demographics, duration of tumor, site, preoperative tumor size, recurrences before MMS, histologic classification of malignancy, postoperative defect size, and 5- year recurrence after MMS. Results: Three thousand three hundred seventy (3370)- patients (1594 female and 1776 male patients) completed a 5- year follow- up period. Fifty- six percent of the tumors were primary and 44% were previously recurrent. Most of them (98.4% ) were located on the head and neck, and the most common histologic subtypes were nodulocystic (29.3% ) and infiltrating (28.3% ). Recurrence at 5 years was diagnosed in 1.4% of primary and in 4% of recurrent tumors. Previous tumor recurrence (P < .001), longer tumor duration before MMS (P=.015), infiltrating histology (P=.13), and more levels for tumor (P < .001)were the main predictors for tumor recurrence after MMS. Limitation: Data were missing for some outcome measures. Conclusion: The low 5- year recurrence rate of BCC with MMS emphasizes the importance of margin- controlled excision.
文摘Background: Perineural invasion (PNI) is an important factor may possibly influence the aggressiveness of basal cell carcinoma (BCC). Objective: Our purpose was to evaluate the incidence, features, and outcomes of BCC with PNI in patients treated with Mohs micrographic surgery (MMS). Method: This prospective, multicenter case series included all patients in Australia treated with MMS for BCC with PNI, who were monitored by the Skin and Cancer Foundation Australia between 1993 and 2002. The parameters recorded were patient demographics, reason for referral, duration of tumor, site, preoperative tumor size, recurrence before MMS, histologic subtypes, postoperative defect size, and recurrence at 5 years after MMS. Results: Two- hundred eighty- three patients were diagnosed with PNI. Most cases occurred in male patients (61% ; P=.006) and in previously recurrent tumors (60.4% ; P < .001). The infiltrating, morpheic, and basosquamous subtypes were more likely to be associated with PNI (P < .0001). Tumor sizes before excision and postoperative defect sizes were significantly larger in cases with PNI compared with cases with no PNI (P < .001 for both parameters), as was the mean number of Mohs excision levels. Seventy- eight patients completed a 5- year follow- up period after MMS, and 6 of them (7.7% ) were diagnosed with recurrence.Limitations: Data were missing for some outcome measures. Conclusion: PNI is an uncommon feature of BCC. When present, PNI is associated with larger, more aggressive tumors, and the risk of 5- year recurrence is higher. This emphasizes the importance of tumor excision with margin control and long- term patient monitoring.
