Konopnicki S, Hermeziu O, Bosc R, Abd Alsamad I, Meningaud J P
Service de chirurgie plastique reconstructrice et esthétique, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
Service de chirurgie plastique reconstructrice et esthétique, centre hospitalier universitaire Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
Ann Chir Plast Esthet. 2016 Aug;61(4):241-7. doi: 10.1016/j.anplas.2016.01.001. Epub 2016 Feb 12.
The purpose of this study was to evaluate the incomplete excision rate of nasal basal cell carcinomas (BCC) resected with different margins to demonstrate that 3-mm surgical margins could be used as safety margins to reduce esthetic consequences with a low risk of incomplete excision.
All patients with BCC of the nose excised from January 1st 2008 to December 31st 2011 were included. Data were analyzed and reviewed retrospectively. Tumors were treated with different surgical margins of excision: 3mm, 4mm, and 5mm. The primary outcome variable was the rate of incomplete excision. Other study variables were the histologic subtype, size, and recurrent lesions.
Of the 132 patients, 115 were included corresponding on with 127 BCC. Median age was 75.5 (64-83) and sex ratio M:F=1.05. Of the 127 BCC, 80 were aggressive histologic subtype (63%), and 11 were recurrent (8.7%). The overall rate of incomplete excision was 17.3% (n=22). Of these 22, 17 (77.3%) were of an aggressive subtype. The incomplete excision rates within the groups were 12.5% (n=4), 22.2% (n=10), and 16% (n=8), respectively within the group with 3-, 4- and 5-mm surgical margins. No significant difference was observed between the groups (P=.519). The incomplete excision rate was not independently associated with the surgical margins, histologic subtype and recurrent type (P>.05).
Three-millimeters margins could possibly be used to treat nasal BCC in chosen cases. Regarding the high rate of incomplete excision, reconstruction should be performed after receiving the pathologic report.
本研究的目的是评估采用不同切缘切除的鼻基底细胞癌（BCC）的不完全切除率，以证明3毫米手术切缘可作为安全切缘，在不完全切除风险较低的情况下减少美学影响。
纳入2008年1月1日至2011年12月31日期间切除的所有鼻基底细胞癌患者。对数据进行回顾性分析和审查。肿瘤采用不同的手术切除切缘进行治疗：3毫米、4毫米和5毫米。主要结局变量是不完全切除率。其他研究变量包括组织学亚型、大小和复发病变。
132例患者中，115例符合纳入标准，共127例基底细胞癌。中位年龄为75.5岁（64 - 83岁），男女比例为1.05。在127例基底细胞癌中，80例为侵袭性组织学亚型（63%），11例为复发病例（8.7%）。总体不完全切除率为17.3%（n = 22）。在这22例中，17例（77.3%）为侵袭性亚型。在手术切缘为3毫米、4毫米和5毫米的组中，不完全切除率分别为12.5%（n = 4）、22.2%（n = 10）和16%（n = 8）。组间未观察到显著差异（P = 0.519）。不完全切除率与手术切缘、组织学亚型和复发类型无独立相关性（P > 0.05）。
在特定病例中，3毫米切缘可能可用于治疗鼻基底细胞癌。鉴于不完全切除率较高，应在收到病理报告后进行重建。
