Wolf D J, Zitelli J A
Arch Dermatol. 1987 Mar;123(3):340-4.
Basal cell carcinomas frequently extend beyond their visible borders. Therefore, the goal of surgical therapy must be to eradicate both the clinically apparent tumor and its microscopic extension into the surrounding normal-appearing skin. This entails excising the tumor along with a margin of clinically normal skin. Unfortunately, there is no agreement as to the optimal width of surgical margins. We therefore studied 117 cases of previously untreated, well-demarcated basal cell carcinoma. Prior to excision, the normal-appearing skin surrounding the tumor was marked in 2-mm increments. The tumor was then excised using Mohs micrographic surgery. The extent of the subclinical tumor invasion was calculated from the presurgical skin markings. For tumors with a diameter less than 2 cm, a minimum margin of 4 mm was necessary to totally eradicate the tumor in more than 95% of cases.
基底细胞癌常常超出其可见边界。因此，手术治疗的目标必须是根除临床上明显的肿瘤及其向周围看似正常皮肤的微小浸润。这需要连同临床上正常皮肤的边缘一并切除肿瘤。不幸的是，对于手术切缘的最佳宽度尚无共识。因此，我们研究了117例未经治疗、边界清晰的基底细胞癌病例。在切除之前，以2毫米的增量标记肿瘤周围看似正常的皮肤。然后使用莫氏显微外科手术切除肿瘤。根据术前皮肤标记计算亚临床肿瘤浸润的范围。对于直径小于2厘米的肿瘤，在超过95%的病例中，至少4毫米的切缘对于完全根除肿瘤是必要的。
