Few Patients With Positive Margins After Basal Cell Excision Have Recurrence

Recurrence developed in more patients who did not receive additional treatment and in fewer receiving nonsurgical treatments

By Elana Gotkine HealthDay Reporter

MONDAY, July 1, 2024 (HealthDay News) — Among patients with incompletely excised basal cell carcinoma (BCC), only about 16 percent with positive histopathologic margins have clinical recurrence, according to a study published online June 13 in Dermatology.

Maria Daviti, M.D., from Aristotle University in Thessaloniki, Greece, and colleagues reported the real-life management of incompletely excised BCC in a tertiary referral center and compared recurrence rates according to management modality in a retrospective study. All BCCs with available histopathologic assay reporting at least one involved margin (lateral or deep) over a five-year period were identified. Patients were categorized into three groups: immediate re-excision (group 1; 26 patients); follow-up without any additional treatment (group 2; 40 patients); and treatment with adjuvant/complementary nonsurgical treatment (group 3; 18 patients).

The researchers found that based on histopathological reports, 53.8 percent of 26 tumors in group 1 that were re-excised had residual tumor. After a mean follow-up of 17 months, a clinical recurrence occurred in 14 of 84 patients (16.7 percent), with a median of 14 months to recurrence. Recurrence developed in 25 percent of the patients without any additional treatment, compared with 11.1 percent of those receiving nonsurgical treatments.

“Our study suggests that positive histopathologic margins after BCC excision result in a clinical recurrence only in a proportion of patients,” the authors write. “This percentage is higher when no further treatment is applied and lower when the area is re-excised or treated with imiquimod alone or combined with cryotherapy.”