Department of Dermatology, Nippon Medical School.
Department of Dermatology, Nippon Medical School, Chiba Hokusoh Hospital.
J Nippon Med Sch. 2024;91(3):296-306. doi: 10.1272/jnms.JNMS.2024_91-308.
Basal cell carcinoma (BCC) is the most common cutaneous malignancy. BCCs occur mainly in exposed areas, such as the face and scalp. Therefore, surgical resection with narrow margins is highly desirable. However, narrow margins may increase the risk of positive histopathological margins. Outcomes for such treatment might be unfavorable, but evidence for such a conclusion is lacking.
Between April 2015 and November 2023, a total of 230 Japanese cases with BCC which underwent surgical resection with 2-mm, 3-mm, or 5-mm margins were followed in our hospital. We conducted a retrospective review that focused on the recurrence rate and histopathological margins.
Recurrence was recorded if the follow-up time was longer than 3 months. One of the 198 cases (0.5%) developed a recurrence. The mean lateral and deep histopathological margins were 2,525.4 μm (30.8-14,034.6 μm) and 3,409 μm (199.9-16,523.6 μm), respectively. Recurrence rate was associated with tumor size and clinical tumor border. However, histopathological margin was not associated with recurrence rate, even when it was less than 1,000 μm.
A narrow histopathological margin is acceptable for surgical resection of BCC in Japanese patients.
基底细胞癌（BCC）是最常见的皮肤恶性肿瘤。BCC 主要发生在暴露部位，如面部和头皮。因此，非常希望进行带窄切缘的外科切除术。然而，窄切缘可能会增加病理切缘阳性的风险。这种治疗的结果可能不理想，但缺乏支持这种结论的证据。
在 2015 年 4 月至 2023 年 11 月期间，我们对在我院接受 2mm、3mm 或 5mm 切缘的 230 例日本 BCC 患者进行了回顾性研究。我们重点关注了复发率和病理切缘。
如果随访时间超过 3 个月，则记录为复发。198 例患者中有 1 例（0.5%）复发。横向和深部病理切缘的平均值分别为 2525.4μm（30.8-14034.6μm）和 3409μm（199.9-16523.6μm）。复发率与肿瘤大小和临床肿瘤边界有关。但是，即使病理切缘小于 1000μm，也与复发率无关。
对于日本患者的 BCC 外科切除术，窄的病理切缘是可以接受的。
