Incidence and factors associated with recurrence after incomplete excision of basal cell carcinomas: a study of 90 cases.

Background Management of incompletely excised basal cell carcinomas (BCC) remains controversial. Objective The aim of this study was to assess the rate and the factors associated with the recurrence of incompletely excised BCC. Methods In this retrospective monocentric study, data from all surgically excised BCC during 4 years (2000 to 2003) were analysed. Results A total of 947 BCC were excised. Of these, 90 were incompletely excised (9.5%). This group was kept under clinical follow-up for a median period of 62.5 months (range 12–84). Recurrence was confirmed in 29 patients (32.2%). The median interval to recurrence was 12 months (range 1–57). Recurrence of incompletely excised BCC was significantly higher (P < 0.05) in younger patients, in aggressive histological types and in localizations like postauricular and nasogenian folds. Conclusion Observation might be an acceptable option in many situations, but for patients with aggressive types of BCC, or with tumours localized in risk areas of the face, immediate re-excision appears to be the treatment of choice. A careful follow-up is indicated for at least 3 years; however, long lasted recurrence should not be underestimated.