Chemosurgery for the microscopically controlled excision of cutaneous cancer.

Cancer of the skin and of other accessible structures can be removed under complete microscopic control if the cancerous area is excised layer by layer, and if the undersurface of each layer is then examined under the microscope through systematic use of frozen sections. If the cancer is extensive and complicated, or if the neoplasm is of a type that is readily disseminated, the tissues are fixed in situ with zinc chloride prior to the excision of each layer (fixed-tissue technique). If the cancer is not overly extensive or complicated, the layers of tissue are excised in the fresh, unfixed state (fresh-tissue technique). Both methods are highly reliable. In two consecutive series of basal-cell carcinomas treated chemosurgically, the five-year cure rate achieved was 99.3% for the 9,351 lesions removed by the fixed-tissue technique, and 98.1% for the 196 lesions removed by the fresh-tissue method.