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CC BY 4.0 · Arch Plast Surg 2024; 51(05): 487-494
DOI: 10.1055/a-2338-9192
Pediatric/Craniomaxillofacial/Head and Neck
Original Article

Is a 3 mm Surgical Margin Safe for Basal Cell Carcinoma in the Head and Neck that is Less than 2 cm, Considering Different Risk Factors?

Authors

  • Min-Jun Yong 

    1   Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine, Gyeongju, Korea

  • Seok-Ju Yoo 

    2   Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea

  • Hea-Kyeong Shin 

    1   Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine, Gyeongju, Korea

Funding None.
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Abstract

Background Basal cell carcinoma (BCC) is the most common type of nonmelanoma skin cancer. Typically, resection requires a safety margin of ≥4 mm. When removing tumor cells, achieving complete excision with minimal safety margins and reconstructing the defect to preserve the original appearance are important. In this study, we used a 3-mm resection margin to confirm recurrence and re-resection rates.

Methods Electronic medical records and photographic data were obtained for patients with primary BCC lesions less than 2 cm in diameter who underwent wide excision with a 3-mm surgical margin from January 2015 to November 2021. We analyzed factors determining recurrence and re-resection rates, such as tumor size, location, age, sex, underlying diseases (including immunosuppression state), ethnicity, subtypes, tumor borders, etc.

Results This study included 205 patients. The mean age and follow-up period were 73.0 ± 11.5 years and 10.2 ± 8.0 months, respectively. The recurrence and re-resection rates were 1.95% and 25.85%, respectively.

A statistically significant correlation was found between recurrence rate and tumor border (p = 0.013) and the re-resection rate was correlated statistically with location (p = 0.022) and immunosuppressed patients (p = 0.006).

Conclusion We found that a 3-mm excision margin provided sufficient safety in small facial BCC, resulting in ease of surgery and better aesthetic outcomes.

However, surgical margins must be determined case by case by integrating various patient factors. In particular, a surgical margin of ≥4 mm is required for BCC in high-risk areas, immunosuppressed patients, or poorly defined border.

Keywords

skin cancer - excision margins - basal cell carcinoma - surgical flap - skin graft

Authors' Contributions

Conceptualization: H.K.S.

Data curation: M.J.Y.

Formal analysis: S.J.Y. and H.K.S.

Writing - original draft: M.J.Y.

Writing - review & editing: H.K.S., M.J.Y.

All authors read and approved the final. manuscript.


Ethical Approval

The study was approved by the Institutional Review Board of Dongguk University Hospital (IRB No. 110757-202211-HR-02-02) and performed in accordance with the principles of the Declaration of Helsinki. The informed consent was waived because this study design is a retrospective chart review.


Patient Consent

The patients' legal guardian provided written informed consent for the publication and the use of patients' images.




Publication History

Received: 12 July 2023

Accepted: 28 May 2024

Accepted Manuscript online:
05 June 2024

Article published online:
06 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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