Retrospective Analysis of the Treatment and Follow-up of 251 Patients with Non-melanoma Skin Cancer in the Mediterranean Region

Abstract

INTRODUCTION: Non-melanoma skin cancer (NMSC) is the most common type of cancer worldwide. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) constitute 99% of NMSCs, with BCC being 3–5 times more common than SCC. This study analyzed the demographic data, treatment and follow-up of patients with NMSC and compared the results with those of previous studies. METHODS: Patients who had been followed-up and treated for NMSC by a single surgeon between January 2014 and January 2018 were evaluated retrospectively. RESULTS: The average age of the 251 patients treated and followed for NMSC was 69.9 years. The incidence of BCC was found to be two times of the SCC. The most frequent tumor localization was the head and neck. Among the head and neck tumors, the incidence of nasal tumors was the highest. Intact surgical margin excisions of 0.5 cm for BCC and 1 cm for SCC were performed. Local flaps were the most common reconstruction option (61.18%). Eleven patients could not be operated on and four of the unoperable tumors were invased to the eye. Positive surgical margins were determined in 4.43% of the patients, but only four patients had disease recurrence during the 25.82 months of follow-up. A new NMSC developed in a different anatomic region in 17 patients. Three of the patients with recurrence died due to NMSC. DISCUSSION AND CONCLUSION: NMSC is easily diagnosed by physical examination and biopsy is not necessary in every case. The incidence of SCC in our series was higher than reported in previous studies. Local flaps were the preferred reconstruction option. The rates of positive surgical margins (4.27%) and relapse (1.31%) were low. This result can be attributed to adequate depth of the excision from the base through the reconstruction of the defect with flap, and the relatively short (< 5 years) follow-up period.