Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland.
Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii.
Otolaryngol Pol. 2022 Jun 1;76(4):1-5. doi: 10.5604/01.3001.0015.8568.
The aim of the study was to ascertain the risk factors of local recurrence in primary basal cell carcinoma of the head and neck Material and methods: A retrospective analysis of 545 patients with head and neck primary basal cell carcinoma treated in years 2008 - 2018 was done. The following data was recorded: age, sex, tumor site, histological subtype, greatest dimension, margin status, experience of operating surgeon and local recurrence Results: Most of the tumors were located nose (165; 30,2%) and auricle (119; 21,8%). The most common pathological subtype was nodular (119; 21,8%). Three hundred and ninety-four tumors (72,2%) were under 20mm in diameter. Positive surgical margins were noted in 107 (19,6%) cases. Local recurrence was observed in 52 (9,5%) cases, of which 29 (29/107; 27%) had positive surgical margins, in 23 (23/438; 5,2%) cases margins were free, which was the only statistically significant factor (p<0,001; OR 6,71; CI 3,69 - 12,2).
The results of our study have shown that positive surgical margin remains the strongest risk factor for local recurrence. With surgical excision being the gold standard of treatment the greatest emphasis should be placed on avoiding such scenario in high risk patients.
本研究旨在确定头颈部原发性基底细胞癌局部复发的危险因素。
对 2008 年至 2018 年期间治疗的 545 例头颈部原发性基底细胞癌患者进行回顾性分析。记录以下数据：年龄、性别、肿瘤部位、组织学亚型、最大直径、切缘状态、手术医生经验和局部复发情况。
大多数肿瘤位于鼻子（165 例；30.2%）和耳朵（119 例；21.8%）。最常见的病理亚型是结节型（119 例；21.8%）。394 个肿瘤（72.2%）直径小于 20mm。107 例（19.6%）存在阳性切缘。52 例（9.5%）观察到局部复发，其中 29 例（29/107；27%）有阳性切缘，23 例（23/438；5.2%）切缘无肿瘤，这是唯一具有统计学意义的因素（p<0.001；OR 6.71；95%CI 3.69-12.2）。
我们的研究结果表明，阳性切缘仍然是局部复发的最强危险因素。手术切除是治疗的金标准，因此应高度重视高危患者避免这种情况。
