author = {El-Bolkainy, Tarek. and Rabie, Ahmed. and Zain, Muhammad. and El-Bolkainy, Nabil.}, title = {{Facial basal cell carcinoma: evaluation of risk factors and adequacy of surgical excision}}, journal ={Menoufia Medical Journal}, volume ={29}, number ={2}, pages = {373-378}, doi = {10.4103/EGJP.EGJP_46_19}, year = {2016}, abstract ={ Background Basal cell carcinoma is the most common malignancy affecting humans but is the least studied. Adequate surgical excision is the only factor to avoid local recurrence, but there is no international agreement on standard guidelines of adequate excision. Aim The aim was to evaluate the adequacy of surgical excision and its relation to risk factors and recurrence. The diagnostic value of tissue markers in difficult cases was studied. Patients and methods A retrospective study was conducted on 214 patients treated by surgery during the period from 2012 to 2016. Adequacy of excision was determined following the guidelines of the European Dermatology Forum. Tumor recurrence was determined on 144 patients with available follow-up (mean, 3.5 years). Three tissue markers were evaluated, namely, CD10 (to exclude basal cell carcinoma mimics), epithelial membrane antigen (to exclude basosquamous carcinoma), and p53 (to confirm high-risk basal cell carcinoma subtypes). Results Inadequate surgical excision was evident in 74.8% of cases. Only females and high-risk sites showed significant association with inadequate excision. Recurrence rate was 16.6% and was higher with inadequate excision (20.4%) than with adequate excision (5.6%). Tissue markers helped to exclude six cases of basal cell carcinoma mimics and confirm the diagnosis of 19 cases of high-risk histology. Conclusions The high-risk rates of inadequate excision and recurrence call for the adoption of standard guidelines for adequate excision and safety margins. Tissue markers are valuable ancillary methods to exclude tumor mimics and confirm high-risk histologic subtypes. }, URL ={http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2016;volume=29;issue=2;spage=373;epage=378;aulast=El;t=6}, eprint ={http://www.mmj.eg.net/article.asp?issn=1110-2098;year=2016;volume=29;issue=2;spage=373;epage=378;aulast=El;t=6} }