Basal cell carcinoma incompletely excised: A case-control study on recurrence

BACKGROUND: There are no univocal opinions on the management of incompletely excised basal cell carcinoma (BCC); early re-excision or clinical observation represent the two possible options. The main objective of the present study was to compare the rate of recurrence between incompletely excised BCCs, not re-excised, and completely excised BCCs within a 3-5 year follow-up period in order to reach indications about the most appropriate care strategy. METHODS: We conducted a case-control study on a cohort of 39 incompletely excised and 107 completely excised BCCs. Patients were recalled for a visit. RESULTS: Three (8%) BCCs recurred among the incompletely excised tumors and 3 (3%) among those completely excised, without significant difference. Advanced age and chronic occupational sun exposure were found to be associated with BCC recurrence. Thirty-seven percent of patients developed new BCCs during follow-up. Half of the patients did not adhere to the scheduled visits after BCC excision. The rate of patients with diagnosis of new or recurrent BCC at the recall visit was higher among non-adherent patients. CONCLUSIONS: In the case of incompletely excised BCCs, long-term clinical observation may be pursued, especially when immediate surgical re-excision is contraindicated. Difficulty in maintaining follow-up due to poor patient adherence represents a concern in clinical practice.