ORIGINAL ARTICLE   Free access

Italian Journal of Dermatology and Venereology 2023 April;158(2):133-9

DOI: 10.23736/S2784-8671.23.07413-3

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Recurrent nasal basal cell carcinoma treated with standard surgery excision: evaluation of volume ratio

Giampietro PINNA ¹, Massimo DELL’ANTONIA ² ✉, Laura ATZORI ², Caterina FERRELI ², Laura CASULA ³, Luigi MINERBA ⁴, Gavino FAA ¹, Franco RONGIOLETTI ⁵, Luca PILLONI ¹

¹ Unit of Pathology Service, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; ² Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; ³ Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy; ⁴ Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; ⁵ Vita Salute University IRCSS San Raffaele Hospital, Milan, Italy

BACKGROUND: Basal cell carcinoma (BCC) is the most common malignant skin tumor. Although it rarely evolves into a metastatic disease, BCC can lead to a significant morbidity due to local invasion. The risk of lesion recurrence depends on clinical and histopathological factors as described by the Nation Comprehensive Cancer Network (NCCN). The surgical excision margins have a well-known role: there is a close relationship between high recurrence rate of BCC and the tumor proximity to the surgical margins. Aim of our study was to assess whether there is a significative correlation between recurring BCC and volume ratio (VRb/t), defined as ratio between excisional biopsy volume and tumor volume, and if VRb/t is a useful parameter to assess the risk of recurrence of BCC.
METHODS: Retrospective case-control study in 80 patients with history of recurrent basal cell carcinoma of the nose (cases), and 43 patients with history of basal cell carcinoma of the nose with no evidence of relapse (controls) in the following 8 years.
RESULTS: Surgical excision margins, histological subtype, ulceration, depth of invasion and volume ratio (VRb/t) were evaluated in case and controls. The evaluation of VRb/t evidenced a significant difference between recurrent BCC and non-recurrent BCC. The mean values of VRb/t were 6.17 for cases and 11.94 for controls. The Binomial Logistic Regression has displayed, for values of VRb/t around 7, a probability of 75% to identify BCCs belonging to the recurrent group.
CONCLUSIONS: Our data show a significant correlation between recurrent BCCs and VRb/t. VRb/t can help in the assessment of recurrence risk, used together with others prognostic factor. For values of VRb/t close to 7 it should be recommended a close follow-up to promptly identify a possible recurrence.

KEY WORDS: Carcinoma, basal cell; Skin neoplasms; Recurrence; Prognosis; Surgery