Analysis of 256 cases of basal cell carcinoma after either one-step or two-step surgery in a Japanese institution
Article first published online: 27 SEP 2011
© 2011 Japanese Dermatological Association
The Journal of Dermatology
Special Issue: Hair Biology and Hair Loss Disorders (pages 1-41)
Volume 39, Issue 1, pages 68–71, January 2012
How to Cite
GOTO, M., KAI, Y., ARAKAWA, S., OISHI, M., ISHIKAWA, K., ANZAI, S., HATANO, Y., OKAMOTO, O., KATAGIRI, K., FUJIWARA, S., SHIMIZU, F., KATO, A., SHIBUYA, H., ESHIMA, N. and TERASHI, H. (2012), Analysis of 256 cases of basal cell carcinoma after either one-step or two-step surgery in a Japanese institution. The Journal of Dermatology, 39: 68–71. doi: 10.1111/j.1346-8138.2011.01306.x
- Issue published online: 29 DEC 2011
- Article first published online: 27 SEP 2011
- Received 18 June 2010; accepted 10 May 2011.
- basal cell carcinoma;
- local recurrence;
- two-step surgery
Basal cell carcinoma (BCC) is a common skin cancer that arises from the cells of the basal layer of the epithelium or from the external root sheath of the hair follicle. In the present report, 256 cases treated surgically between 1999 and 2008 in our department were retrospectively analyzed. The most frequent BCC locations included the face (77.8%), especially the nose (26.9%) and eyelids (21.5%). Incomplete excisions occurred in 21 cases. Two patients experienced local recurrence; one of these patients exhibited a bone metastasis while the other had a metastasis of the parotid gland without the local recurrence. The rate of local BCC recurrence was 0.78%, which is lower than that described in previous reports. We categorized BCC into four histological types: superficial, solid, adenoid and infiltrative. The solid type was the most frequent histological type (62.1%). For preventive recurrence, we treated BCC patients with two-step surgery when the tumor was large or histologically invasive. At the first step, we excised the tumor with a sufficient safety margin, and at the second step, we performed reconstruction after the histological confirmation that no remnant malignant cells were in the tumor margins. In the present report, no local recurrence occurred in patients following the two-step surgery. Therefore, two-step surgery is recommended for tumors at locations and with histological types related to frequent recurrence.