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Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma* * Study conducted at Centro de Cirurgia da Pele – Rio de Janeiro (RJ), Brazil.

Abstract

BACKGROUND:

Surgical excision is the treatment of choice for basal cell carcinoma and micrographic surgery considered the gold standard, however not yet used routinely worldwide available, as in Brazil. Considering this, a previously developed treatment guideline, which the majority of tumors were treated by conventional technique (not micrographic) was tested.

OBJECTIVE:

To establish the recurrence rate of basal cell carcinomas treated according to this guideline.

METHOD:

Between May 2001 and July 2012, 919 basal cell carcinoma lesions in 410 patients were treated according to the proposed guideline. Patients were followed-up and reviewed between September 2013 and February 2014 for clinical, dermatoscopic and histopathologic detection of possible recurrences.

RESULTS:

After application of exclusion criteria, 520 lesions were studied, with 88.3% primary and 11.7% recurrent tumors. Histological pattern was indolent in 85.5%, 48.6% were located in high risk areas and 70% small tumors. Only 7.3% were treated by Mohs micrographic surgery. The recurrence rate, in an average follow-up period of 4.37 years, was 1.3% for primary and 1.63% for recurrent tumors. Study limitations: unicenter study, with all patients operated on by the same surgeon.

CONCLUSION:

The treatment guideline utilized seems a helpful guide for surgical treatment of basal cell carcinoma, especially if micrographic surgery is not available.

Keywords:
Mohs surgery; Carcinoma, basal cell; Treatment outcome; Recurrence

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