Risk factors for local recurrence of basal cell carcinoma and cutaneous squamous cell carcinoma of the middle third of the face: a 15-year retrospective analysis based on a single centre

Eur J Dermatol. 2019 Oct 1;29(5):490-499. doi: 10.1684/ejd.2019.3643.

Abstract

Non-melanoma skin cancer (NMSC) is the commonest malignancy worldwide (>80% located in the head and neck area). The aim of this study was to assess risk factors predisposing to local recurrence of NMSC of the middle third of the face (MTF). This was a single-centre retrospective analysis of patients with NMSC of the MTF treated during 1995-2010. Data on epidemiological and tumour characteristics were collected. Survival analysis was performed and log-rank tests were used to compare differences in survival for each variable. A total of 531 patients with basal cell carcinoma (BCC) of the MTF were identified. Most tumours were nodular type (28.4%), located on the nose (34.3%), and confined to the dermis (75.5%). Negative margins were achieved in 91% of cases. Median follow-up time was 35 months and 15.2% of patients developed local recurrence. Incomplete excision was the only variable predisposing to local recurrence. The cohort also included 114 patients with squamous cell carcinoma (SCC). Most tumours were well differentiated (43.9%), located at the zygomatic area (49.1%), excised with negative margins (93%), and confined to the dermis (67.8%). At a median follow-up time of 42 months, local recurrence occurred in 15.7% of patients. Tumour size, depth of invasion, and prior history of head and neck SCC were risk factors for local recurrence. The variables predictive of recurrence of BCC were incomplete excision and for SCC tumour size, depth of invasion, and a prior history of head and neck SCC.

Keywords: basal cell carcinoma; cutaneous squamous cell carcinoma; middle third of the face; recurrence; risk factors.

MeSH terms

  • Aged
  • Carcinoma, Basal Cell / pathology*
  • Carcinoma, Basal Cell / radiotherapy
  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Disease-Free Survival
  • Facial Neoplasms / pathology*
  • Facial Neoplasms / radiotherapy
  • Facial Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / pathology*
  • Retrospective Studies
  • Risk Factors
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / radiotherapy
  • Skin Neoplasms / surgery
  • Tumor Burden