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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2001 December;12(3):149-52
Basal cell carcinoma of the head and neck. Our experience during 1990-2000
Tartaro G. P., Gaetani L., Battista C., Pavone E.
From the Chair of Oral and Maxillo-Facial Surgery Faculty of Medicine and Surgery Naples II University, Naples, Italy
Background. A retrospective study compares different types of treatment for basal cell carcinoma. Alternatives to surgery (cryotherapy, photodynamic therapy) were found to be less effective surgery, which may be considered the elective treatment, having greater efficacy in the definitive enucleation of the tumour.
Methods. A total of 140 patients suffering from basal cell carcinoma of the head and neck presented to our observation during the 10-year period of this study; M/F ratio was 2:1. Forty of these patients were excluded from the study owing to the presence of associated diseases (heart disease, liver disease, diabetes, kidney disease, lung disease, etc.). Sixty-nine of the remaining patients had undergone surgical excision of the tumour including a margin of approximately 1 cm of healthy tissue; this was followed by histological examination to verify adequacy of resection margins and depth. Thirty-one patients had undergone non-surgical treatment (20 with cryotherapy and 11 with photodynamic therapy). Follow-up was at 1, 3, 6 and 12 months from surgery and thereafter annually.
Results. In the surgically-treated group, 2 relapses were found at 3 months; 3 relapses at 6 months; 1 relapse at 12 months; no further relapses occurred subsequently. Of the 31 patients treated with non-surgical therapy, 12 suffered a relapse.
Conclusions. Surgical treatment of basal cell carcinoma is, in our experience, the elective treatment to obviate against the problem of relapse, above all long-term relapse. Results of cryotherapy, photodynamic therapy and other treatments are not encouraging, providing insufficiently radical excision.