Narrow-margin excision is a safe, reliable treatment for well-defined, primary pigmented basal cell carcinoma: an analysis of 288 lesions in Japan

作者：Ito T^*; Inatomi Y; Nagae K; Nakano Nakamura M; Nakahara T; Furue M; Uchi H

来源：Journal of the European Academy of Dermatology and Venereology, 2015, 29(9): 1828-1831.

DOI：10.1111/jdv.12689

BackgroundComplete excision is the most promising treatment for basal cell carcinoma (BCC) and a surgical margin of at least 4mm is recommended. However, little is known about the appropriate surgical margin of pigmented BCC.
ObjectiveTo investigate the reliability of narrower margin excision of well-defined, pigmented BCC.
MethodsWe identified a total of 263 patients with 288 well-defined, primary pigmented BCC at the Department of Dermatology, Kyushu University (Fukuoka, Japan), between January 2006 and December 2013. All lesions were surgically excised with 1-6-mm margins and analysed. For 30 recent lesions out of the 288 lesions, border gaps between dermoscopy and histopathology were assessed.
ResultsOf the 288 lesions, 218 (75.7%) were excised with a narrow margin (3mm) and 60 lesions (24.3%) with a wide margin (4mm). Only two lesions (0.7%), which were excised with 2-mm margins, were associated with tumour-positive margins. Narrow-margin excision showed a complete removal rate of 99% (2-mm margins, 95.3%; 3-mm margins, 100%). Dermoscopically determined borders almost exactly corresponded to the histopathological ones; 71.2% of border gaps between dermoscopy and histopathology were within 1mm and there were no cases in which tumours spread beyond 1mm of their dermoscopic borders.
ConclusionSurgical excision with a 2-3-mm margin is reliable treatment for well-defined, primary pigmented BCC, with a complete removal rate of 99%.

• 出版日期2015-9