Value of Intraoperative Retakes During Standard Resection of Basal Cell Carcinoma (BCC) of the Head and Neck

Abstract

Background: The lowest recurrence rates for basal cell carcinoma are achieved by surgical treatment. Low rates of residual tumour in specimens after incomplete excisions plus intraoperative frozen section accuracy are the rationale for analyzing the value of intraoperative re-excisions during basal cell carcinoma standard surgery.

Objective: To analyse intraoperative oncologic and cosmetic results of re-captures in patients surgically treated of basal-cells carcinoma. Secondary to analyse subclinic extention, the value of frozen intraoperative sections and reconstructive conducts employed. Setting: tertiary care Hospital of tumours.

Methods: Observational retrospective study. During 3-year period 84 tumours were resected. A comparative analysis in terms of recurrence, surgical defect and use of flaps was done between intraoperatively re-excised and not re-excised tumours.

Results: There were no statistical difference regarding recurrence rate and use of flaps. Mean surgical defect for re-excised and not re-excised specimens was 27,8mm and 22,8mm respectively, being the difference statistically significant (p=0.002). Residual tumour was found in only 2,9% of re-excised specimens.

Conclusions: Re-excisions added on average 5mm to surgical defect per specimen and did not contribute to any benefit in terms of recurrence rates. A more conservative use of intraoperative re-excisions could improve functional and cosmetic outcomes.