Iurilli Martin, Cazzato Vito, Ramella Vittorio, Papa Giovanni
Department of Plastic and Reconstructive Surgery, ASUGI, University of Trieste, Trieste, Italy.
Arch Dermatol Res. 2025 Mar 19;317(1):604. doi: 10.1007/s00403-025-04084-3.
Basal cell carcinoma (BCC) is the most common type of skin cancer globally, with its prevalence increasing due to chronic ultraviolet (UV) radiation exposure. Although surgical excision remains the cornerstone of treatment, achieving optimal outcomes requires a careful balance between complete tumor removal and the preservation of cosmetic appearance.
This study aims to investigate the relationship between excision margins, reoperation rates, and BCC recurrence through a retrospective analysis of 3036 surgical excisions.
Conducted at the Department of Plastic Surgery in Trieste, Italy, this study includes data from 2037 patients treated between 2014 and 2018. Excision procedures adhered to standardized hospital protocols. Tumor characteristics, excision margins, and involved anatomical sites were analyzed.
The study demonstrated an equal gender distribution (51.02% women), with the nodular subtype (45.85%) being the most common. The head was the most frequently affected site (54.74%). A complete excision rate of 93.3% was achieved, but incomplete excisions were more common in head and neck locations and certain histological subtypes. Surgical reinterventions were primarily performed for high-risk BCCs, significantly reducing recurrence rates (0.52%).
Reoperation, especially for high-risk BCCs, should be prioritized over conservative management to minimize recurrence. Narrow excision margins were associated with higher recurrence rates, highlighting the importance of adequate margin clearance. This study enhances understanding of the complex interplay between excision techniques, reoperation, and long-term outcomes in BCC management.
基底细胞癌（BCC）是全球最常见的皮肤癌类型，由于长期暴露于紫外线（UV）辐射，其患病率呈上升趋势。尽管手术切除仍然是治疗的基石，但要实现最佳效果，需要在完全切除肿瘤和保持外观之间仔细权衡。
本研究旨在通过对3036例手术切除病例的回顾性分析，探讨切除边缘、再次手术率与基底细胞癌复发之间的关系。
本研究在意大利的里雅斯特市整形外科进行，纳入了2014年至2018年期间接受治疗的2037例患者的数据。切除手术遵循标准化的医院方案。对肿瘤特征、切除边缘和受累解剖部位进行了分析。
该研究显示，男女分布均衡（女性占51.02%），结节型亚型最为常见（占45.85%）。头部是最常受累的部位（占54.74%）。完全切除率达到93.3%，但不完全切除在头颈部和某些组织学亚型中更为常见。再次手术主要针对高危基底细胞癌，显著降低了复发率（0.52%）。
为了尽量减少复发，应优先考虑再次手术，尤其是对于高危基底细胞癌，而不是保守治疗。切除边缘狭窄与较高的复发率相关，突出了足够切缘清除的重要性。本研究增进了对基底细胞癌治疗中切除技术、再次手术和长期结果之间复杂相互作用的理解。
