Luz Flávio Barbosa, Ferron Camila, Cardoso Gilberto Perez
Universidade Federal Fluminense (UFF) - Niterói (RJ), Brazil.
Private clinic - Rio de Janeiro (RJ), Brazil.
An Bras Dermatol. 2016 Nov-Dec;91(6):726-731. doi: 10.1590/abd1806-4841.20165919.
: Surgical excision is the treatment of choice for basal cell carcinoma and micrographic surgery considered the gold standard, however not yet used routinely worldwide available, as in Brazil. Considering this, a previously developed treatment guideline, which the majority of tumors were treated by conventional technique (not micrographic) was tested.
: To establish the recurrence rate of basal cell carcinomas treated according to this guideline.
: Between May 2001 and July 2012, 919 basal cell carcinoma lesions in 410 patients were treated according to the proposed guideline. Patients were followed-up and reviewed between September 2013 and February 2014 for clinical, dermatoscopic and histopathologic detection of possible recurrences.
: After application of exclusion criteria, 520 lesions were studied, with 88.3% primary and 11.7% recurrent tumors. Histological pattern was indolent in 85.5%, 48.6% were located in high risk areas and 70% small tumors. Only 7.3% were treated by Mohs micrographic surgery. The recurrence rate, in an average follow-up period of 4.37 years, was 1.3% for primary and 1.63% for recurrent tumors. Study limitations: unicenter study, with all patients operated on by the same surgeon.
: The treatment guideline utilized seems a helpful guide for surgical treatment of basal cell carcinoma, especially if micrographic surgery is not available.
手术切除是基底细胞癌的首选治疗方法，而显微外科手术被视为金标准，但在全球范围内，如巴西，尚未常规使用。考虑到这一点，对先前制定的治疗指南进行了测试，该指南中大多数肿瘤采用传统技术（非显微技术）治疗。
确定根据该指南治疗的基底细胞癌的复发率。
2001年5月至2012年7月期间，410例患者的919个基底细胞癌病灶按照提议的指南进行治疗。2013年9月至2014年2月对患者进行随访和复查，以进行临床、皮肤镜和组织病理学检查，检测可能的复发情况。
应用排除标准后，研究了520个病灶，其中原发性肿瘤占88.3%，复发性肿瘤占11.7%。组织学类型为惰性的占85.5%，48.6%位于高危区域，70%为小肿瘤。仅7.3%采用莫氏显微外科手术治疗。在平均4.37年的随访期内，原发性肿瘤的复发率为1.3%，复发性肿瘤的复发率为1.63%。研究局限性：单中心研究，所有患者均由同一位外科医生进行手术。
所采用的治疗指南似乎是基底细胞癌手术治疗的有益指导，尤其是在无法进行显微外科手术的情况下。
