Dika Emi, Veronesi Giulia, Patrizi Annalisa, De Salvo Sara, Misciali Cosimo, Baraldi Carlotta, Mussi Martina, Fabbri Erich, Tartari Federico, Lambertini Martina
Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Plastic Surgery Unit, ospedale Bellaria, Bologna, Italy.
Dermatol Ther. 2020 Jul;33(4):e13474. doi: 10.1111/dth.13474. Epub 2020 May 18.
Basal cell carcinoma (BCC) is the most common variety of non-melanoma skin cancer and its incidence is increasing worldwide. The centrofacial sites (area H) are considered a high-risk factor for BCC local recurrence. Mohs micrographic surgery (MMS) is a technique that allows intraoperative microscopic control of the surgical margins and is a good treatment option when tissue conservation is required for esthetic or functional reasons or for high-risk lesions. The present study aimed to evaluate the recurrence rate of head and neck high-risk BCCs comparing MMS vs conventional surgical excision. Clinical data of patients diagnosed from September 2014 to March 2017, referring to the Dermatology Unit of the Policlinico Sant'Orsola-Malpighi, University of Bologna, were retrospectively evaluated (285 treated with MMS and 378 treated with traditional surgery). Of the 285 patients treated with MMS, 9 experienced a recurrence (3.1%). Of the 378 patients treated with traditional surgery, 53 relapsed (14%), 13 of whom presented residual tumor on the deep or lateral margins of the main surgical specimen. Our study confirms the trend reported in the literature that MMS represents the best treatment option for high-risk BCCs arising in the head and neck region or presenting as a recurrence (P < .00001). Many more MMS centers and more trained dermatologists are needed worldwide in order to deal with the increasing number of BCC diagnosed every year.
基底细胞癌（BCC）是最常见的非黑色素瘤皮肤癌类型，其发病率在全球范围内呈上升趋势。面部中央部位（区域H）被认为是BCC局部复发的高危因素。莫氏显微外科手术（MMS）是一种能够在术中对手术切缘进行显微镜控制的技术，当出于美学或功能原因或针对高危病变需要保留组织时，它是一种很好的治疗选择。本研究旨在比较MMS与传统手术切除治疗头颈部高危BCC的复发率。回顾性评估了2014年9月至2017年3月在博洛尼亚大学圣奥索拉 - 马尔皮基综合医院皮肤科诊断的患者的临床数据（285例接受MMS治疗，378例接受传统手术治疗）。在接受MMS治疗的285例患者中，9例出现复发（3.1%）。在接受传统手术治疗的378例患者中，53例复发（14%），其中13例在主要手术标本的深部或侧缘出现残留肿瘤。我们的研究证实了文献中报道的趋势，即MMS是头颈部区域发生的高危BCC或复发性BCC的最佳治疗选择（P <.00001）。为了应对每年诊断出的BCC数量不断增加的情况，全球需要更多的MMS中心和更多经过培训的皮肤科医生。
