Facial basal cell carcinoma: a clinicopathological analysis of incomplete excision

Basal cell carcinoma (BCC) is the most common malignancy in humans. Incomplete excision following conventional surgical excision requires careful consideration given the potential for disease recurrence. We performed a retrospective study analyzing facial BCC treated by conventional surgical excision to investigate factors influencing the likelihood of tumour clearance. In total, 456 cases of facial BCC were reviewed to collect a dataset of 50 tumours with involved margins and these compared to 50 completely excised tumours from the same cohort. Statistical comparison between incomplete and complete excision cases was performed using several metrics including tumour location, histology, grade, surgeon experience and method of wound reconstruction. Interestingly, our results demonstrated that only tumour location and histological type had a statistically significant impact on the completeness of resection. Infiltrative, morphoeic and mixed tumours had a higher chance of incomplete excision, as did tumours located on the inner canthus and ala nasi. In addition, the overall incomplete excision rate was 10.96% in line with previous studies. Our results help inform surgical practice and support consideration of extending the recommended macroscopic surgical margin for higher risk tumours. More research is needed to further categorize facial BCC to optimize surgical management.