Treatment of Pigmented Basal Cell Carcinoma with 3 mm Surgical Margin in Asians

الملخص EN

Background.

In Asians, most basal cell carcinomas (BCCs) are pigmented with clear borders.

The consensus of 4 mm surgical margin for BCC largely depends on studies in nonpigmented BCCs in Caucasians.

However, little is known about recurrences of pigmented BCCs with a narrower surgical margin.

We aimed to investigate 5-year recurrence of BCCs, either pigmented or nonpigmented, in Taiwanese with 3 mm surgical margin.

Materials and Methods.

143 patients with BCC (M/F = 66/77, average 64 years) were confirmed pathologically from 2002 to 2013.

Based on the pathological margin (>1 mm, ≤1 mm, and involved), patients were categorized into the complete excision group ( n = 77 ), histology with close proximity group ( n = 43 ), and unclear surgical margin group ( n = 23 ).

Results.

Among 143 cases, 105 were pigmented.

With standard 3 mm excision, there were 7 recurrences, with 6 of them from nonpigmented BCC group.

Logistic regression showed that pigmentation was associated with lower recurrence.

Interestingly, 5-year recurrence of completely excised and histology with close proximity BCC (0/77 versus 1/43) was not different statistically.

Conclusions.

A 3 mm surgical margin is adequate for pigmented BCC.

A “wait and see” approach rather than further wide excision is appropriate for BCC with <1 mm free margin.