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Rivista Italiana di Chirurgia Maxillo-Facciale 2001 December;12(3):149-52

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

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


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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.

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