Review of outcomes of 500 consecutive cases of non-melanoma skin cancer of the head and neck managed in an oral and maxillofacial surgical unit in a District General Hospital

• Published in: British journal of oral & maxillofacial surgery Vol. 56; no. 9; pp. 805 - 809
• Main Authors: Dalal, A.J., Ingham, J., Collard, B., Merrick, G.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.11.2018
• Subjects: Aged; Basal cell carcinoma; Carcinoma, Basal Cell - surgery; Carcinoma, Squamous Cell - surgery; Dermatologic Surgical Procedures - methods; England; Female; Head and neck; Head and Neck Neoplasms - surgery; Hospitals, General; Humans; Male; Middle Aged; Non-melanoma skin cancer; Retrospective Studies; Skin Neoplasms - surgery; Squamous cell carcinoma; Surgical excision; Treatment Outcome; England; Head and neck; Squamous cell carcinoma; Surgical excision; Basal cell carcinoma; Non-melanoma skin cancer
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2018.08.015

We provide a non-melanoma skin cancer (NMSC) service for skin cancers of the head and neck in the south-west of England. We hypothesised that certain anatomical sites such as the nose and eyelid would have a higher incidence of close or involved margins than others, and that the choice of repair might influence the excised margins. We therefore retrospectively analysed the data of 500 consecutive NMSC that were operated on in the oral and maxillofacial surgery unit of Taunton and Somerset NHS Trust. The database reports were crosschecked against the Trust’s own pathology reporting system to ensure that they were accurate. Data collected included clinical and personal details of patients, anatomical sites, type of reconstruction, histopathological diagnosis, excision margins, and complications. Of the 500 patients reviewed 362 (72%) were basal cell carcinomas (BCC) and 138 (28%) squamous cell carcinomas (SCC). The outcomes of 243 patients treated by primary closure, 134 treated by reconstruction with local flaps, and 123 treated by skin grafts, were reviewed with particular attention paid to the anatomical site and excision margins. There was an overall incomplete excision rate of 10.8% (n=54) and 29 patients developed complications (5.8%). We confirmed that rates of close or incomplete margins are more likely in certain anatomical sites such as the nose, forehead, and ear. The rate of involved margins was unaffected by choice of surgical technique.