Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden. E-mail:
Acta Derm Venereol. 2021 Jul 13;101(7):adv00496. doi: 10.2340/00015555-3856.
Research has shown higher rates of incomplete excision among high-risk than low-risk basal cell carcinomas, but data is limited. A single-centre, retrospective study including excised high-risk basal cell carcinomas (type II-III according to the Swedish classification) was performed to determine incomplete excision rates and associated clinicopathological risk factors. Overall, 987 consecutive cases were included. Of these, 203 (20.6%) were incompletely excised. Incomplete excision rates were higher for type III basal cell carcinomas (27.0% vs 17.6% for type II, p < 0.001) and localization on the face and scalp (22.4% vs 14.7% for other locations, p = 0.009), especially on the nose, ear, scalp and periorbital area (28.0-37.0% vs 9.5-16.9% for other locations, p < 0.0001). Circular excisions were also more often incomplete (28.5%) compared with elliptical excisions (17.7%) (p < 0.001). No association was found between incomplete excision rates and tumour size, excision margins, use of a preoperative biopsy or surgeon experience. Mohs micrographic surgery should be used more often for type II-III basal cell carcinomas on the face and scalp.
研究表明，高危基底细胞癌的不完全切除率高于低危基底细胞癌，但数据有限。本研究为单中心回顾性研究，纳入了切除的高危基底细胞癌（根据瑞典分类为 II-III 型），旨在确定不完全切除率及相关临床病理危险因素。共纳入 987 例连续病例，其中 203 例（20.6%）为不完全切除。III 型基底细胞癌的不完全切除率更高（27.0%比 II 型的 17.6%，p<0.001），面部和头皮的定位（22.4%比其他部位的 14.7%，p=0.009），尤其是鼻、耳、头皮和眶周（28.0-37.0%比其他部位的 9.5-16.9%，p<0.0001）。圆形切除的不完全切除率也高于椭圆形切除（28.5%比 17.7%，p<0.001）。不完全切除率与肿瘤大小、切除边缘、术前活检的使用或外科医生经验无关。Mohs 显微外科手术应更多地用于面部和头皮的 II-III 型基底细胞癌。
