Our Principles of Diagnosis and Treatment in Basal Cell Carcinoma

Yıl 2014, Cilt: 47 Sayı: 1, 1 - 6, 21.08.2014

Hakan Uzun Ozan Bitik

https://doi.org/10.5505/aot.2014.65375

Öz

OBJECTIVE: In this study, authors aimed to retrospectivcely analyse the surgeries performed for basal cell carcinoma (BCC) in Ankara Oncology Hospital and they also aimed to settle the principles for diagnosis and treatment of BCC through the experiences gained.
METHODS: 7018 patients, excluding the trauma cases, were admitted to plastic, reconstructive and aesthetic surgery clinic between 2010 and 2012. 423 patients with the diagnosis of BCC were retrospectively reviewed by means of sex, age, symptom, location, type of surgery and recurrence.
RESULTS: The patients who were operated for BCC constituted 6% of the patients who admitted to Plastic and Reconstructive surgery clinic. 63.1% of the patients was male and 39.6% was female. 491 malignant tumor excisions were performed from the patients. It was seen that the lesions were most commonly located on head and neck region (89,2%). 26.2% of the patients was treated with excision and primary closure. 64.3% of the patients was treated with excision and local flap. 9.5% of the patients was treated with excision and grafting. Of the patients who were operated, 1.9% had recurrence and 9 patients were reoperated due to residual tumor.
CONCLUSION: Our study reflects the 2-year experience of our clinic. Early diagnosis and treatment are very important to prevent the spread of the lesions and to decrease the recurrence. We should always work in coordination with radiation oncology department. Executing these kind of studies provides standardization of the principles for the diagnosis and treatment.

Anahtar Kelimeler

Skin Cancer, Basal Cell Carcinoma; Recurrence.

Bazal Hücreli Karsinomada Tanı ve Tedavi Prensiplerimiz

Öz

AMAÇ: Bu çalışma ile Ankara Onkoloji Hastanesi'nde gerçekleştirilen bazal hücreli karsinoma (BHK) ameliyatlarını retrospektif olarak değerlendirmek ve elde edilen deneyim sonucunda tanı ve tedavi prensiplerini oluşturmak amaçlandı.
YÖNTEMLER: 2010-2012 yılları arasında plastik, rekonstrüktif ve estetik cerrahi polikliniğine, travma hastaları hariç, 7018 hasta başvurdu. BHK tanısı ile ameliyat edilen 423 hastanın dosyaları ve patoloji raporları retrospektif olarak ve cinsiyet, yaş, semptom, lokalizasyon, uygulanan cerrahi yöntem, rekürrens gibi değişkenler göz önüne alınarak tarandı.
BULGULAR: BHK nedeniyle ameliyat edilen hastalar, plastik, rekonstrüktif ve estetik cerrahi polikliniğine başvuran hastaların %6’sını oluşturdular. Hastaların %63,1’i erkek, %36,9’u kadındı. Ameliyat edilen hastalardan toplam 491 malign lezyon eksizyonu yapıldı. Lezyonların en sık baş boyun bölgesinde yerleştiği görüldü (%89,2). Hastaların %26,2’si eksizyon ve primer onarım ile, %64,3’ü eksizyon ve lokal flep ile, %9,5’i eksizyon ve greftleme ile tedavi edildi. Ameliyat sonrası tüm hastaların %1,9’unda rekürrens saptandı ve 9 hasta rezidü tümör nedeniyle yeniden ameliyat edildi.
SONUÇ: Çalışmamız kliniğimizin 2 yıllık tecrübesini yansıtmaktadır. Erken tanı ve tedavi lezyonların yayılımının engellenmesi ve rekürrensin azaltılması açısından çok önemlidir. Radyasyon onkolojisi bölümü ile koordinasyon halinde çalışılmalıdır. Buna benzer çalışmaların yapılması, tanı ve tedavi prensiplerinin standardize edilmesini sağlamaktadır.

Anahtar Kelimeler

Deri Kanseri, Bazal Hücreli Karsinoma; Rekürrens.

Kaynakça

• Lomas A, Leonardi-Bee J, Bath-Hextall F. A systematic review of worldwide incidence of nonmelanoma skin cancer. Br J Dermatol 2012;166:1069-80.
• Rogers HW, Weinstock MA, Harris AR, et al. Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol 2010;146:283-7.
• Gulleth Y, Goldberg N, Silverman RP, Gastman BR. What is the best surgical margin for a Basal cell carcinoma: a meta-analysis of the literature. Plast Reconstr Surg 2010;126:1222-31.
• Chinem VP, Miot HA. Epidemiology of basal cell carcinoma. An Bras Dermatol 2011;86:292-305.
• Brana I, Siu LL. Locally advanced head and neck squamous cell cancer: treatment choice based on risk factors and optimizing drug prescription. Ann Oncol 2012;23 Suppl 10:x178-85.
• Gürsan N, Kabalar E, Yıldırım Ü. Bazal hücreli karsinomların klinik ve histopatolojik degerlendirilmesi. Turk J Dermatopathol 2000;9:23-8.
• Roewert-Huber J, Lange-Asschenfeldt B, Stockfleth E, Kerl H. Epidemiology and aetiology of basal cell carcinoma. Br J Dermatol 2007;157 Suppl 2:47-51.
• Tiftikcioglu YO, Karaaslan O, Aksoy HM, Aksoy B, Kocer U. Basal cell carcinoma in Turkey. J Dermatol 2006;33:91-5.
• Hoban PR, Ramachandran S, Strange RC. Environment, phenotype and genetics: risk factors associated with BCC of the skin. Expert Rev Anticancer Ther 2002;2:570-9.
• Lear JT, Smith AG, Strange RC, Fryer AA. Patients with truncal basal cell carcinoma represent a high-risk group. Arch Dermatol 1998;134:373. van Zuuren EJ, Bastiaens MT, Posma AN, Bouwes Bavinck JN. Basal cell carcinoma on the dorsum of the hand: report of 11 cases. J Eur Acad Dermatol Venereol 2000;14:307-10.
• Kossard S, Epstein E, Cerlo R, Yu L, Weedon D. Basal Cell Carcinoma. In: WHO histological classification of keratinocytic skin tumours; 2006:13-9.
• Barton M. Malignant Tumors of the Skin. In: Mathes S, ed. Plastic Surgery; 2006:273-304.
• Staub G, Revol M, May P, Bayol JC, Verola O, Servant JM. [Excision skin margin and recurrence rate of skin cancer: a prospective study of 844 cases]. Ann Chir Plast Esthet 2008;53:389-98.
• Kopke LFF, Schmidt SM. Carcinoma basocelular. An Bras Dermatol 2002;77:249
• Kılıç S. Kseroderma pigmentosum. Güncel Pediatri 2004;2:137-9.
• Eskiizmir G, Cingi C. Nonmelanoma skin cancer of the head and neck: current diagnosis and treatment. Facial Plast Surg Clin North Am 2012;20:415-7.
• Lien MH, Sondak VK. Nonsurgical treatment options for Basal cell carcinoma. J Skin Cancer 2011;2011:571734.
• Thomas DJ, King AR, Peat BG. Excision margins for nonmelanotic skin cancer. Plast Reconstr Surg 2003;112:57-63.
• Madan V, Lear JT, Szeimies RM. Nonmelanoma skin cancer. Lancet 2010;375:673
• Sexton M, Jones DB, Maloney ME. Histologic pattern analysis of basal cell carcinoma. Study of a series of 1039 consecutive neoplasms. J Am Acad Dermatol 1990;23:1118-26.
• Bogelund FS, Philipsen PA, Gniadecki R. Factors affecting the recurrence rate of basal cell carcinoma. Acta Derm Venereol 2007;87:330-4.
• Nagore E, Grau C, Molinero J, Fortea JM. Positive margins in basal cell carcinoma: relationship to clinical features and recurrence risk. A retrospective study of 248 patients. J Eur Acad Dermatol Venereol 2003;17:167-70. Dubin N, Kopf AW. Multivariate risk score for recurrence of cutaneous basal cell carcinomas. Arch Dermatol 1983;119:373-7.