Investigating determinants of surgical success in excising basal cell and cutaneous squamous cell carcinomas of the head and neck: A single-center retrospective analysis

This study aimed to identify factors influencing the completeness of primary and re-excision of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (SCC), and cutaneous carcinoma in situ (CIS) of the head and neck. A retrospective single-center analysis was conducted, encompassing 1513 instances of cutaneous tumors recorded between 2015 and 2022. This dataset comprised 1108 primary excisions and 405 re-excisions, all of which were histologically verified cases of BCC, SCC, and CIS located within the head and neck region. Correlation analyses were performed, considering variables such as patients' gender and age, tumor localization, preoperative suspicion or histological confirmation of skin tumor diagnosis, surgeons’ levels of training, and the utilization of magnifying glasses. The primary objective was to assess the impact of these factors on the completeness of both primary and re-excisions of skin tumors. The analysis revealed a significant correlation between the localization of BCC and the completeness of primary excision. Specifically, the nose and ear exhibited a significantly higher rate of incomplete excisions (R1), whereas the cheek demonstrated a substantial reduction in the R1 rate. The utilization of magnifying glasses exhibited a positive correlation with the completeness of primary BCC excision. However, no discernible influencing factors were identified for BCC re-excisions and the combined group of primarily and re-excised cutaneous squamous cell carcinoma (SCC) and carcinoma in situ (CIS). Tumor entity and localization emerged as crucial factors influencing the completeness of skin tumor excisions, with specific anatomical sites exhibiting varying rates of incomplete procedures. Notably, the use of magnifying glasses demonstrated a significant positive correlation with reduced rates of incomplete excisions, re-excisions, and subsequent procedures, suggesting its potential as a valuable tool in enhancing surgical precision and optimizing outcomes.