Analysis Of Basal Cell Carcinoma In Maxillofacial Area-Epidemiology And Surgical Margin 1996 To 2003

Background: Basal cell carcinoma (BCC) is the most common cutaneous malignancy, accounting for 65% to 75% of all skin cancers. A major upward trend in the incidence of BCC has been noted worldwide, resulting from aging population and increasing sunlight exposure, although epidemiological data is deficient in China. The morbidity is relatively high in old male, but it is increasing among young female now. BCC usually occurs in maxillofacial area, which causes cosmetic impairment;the epidemiological data around the world indicate nasal area is the most affected site. BCC rarely metastasis. Up until now, there is no specific standard for clinical surgical margin. This study aimed to present incidence rates and anatomic sites, the relationship between surgical margin and metastasis—in the 41 cases of BCCs in our hospital during 8 years.Method: Retrospective study was undertaken of 41 cases BCCs of the maxillofacial region diagnosed in histopathology during the period 1996 to 2003, of whom 17 were males and 24 were females;The age of BCCs patients was between 55-74 years old, the average age of female patients was 68.1 years old, and that of the male was 58.4 years old. The lesions of BCCs were seen on the nose 13 cases (31.7%), scalp skin 8 cases (19.5%), periorbital skin 7 cases (17.1 %), perioral 7 cases (17.1 %), cheek skin 4 cases (9.76%) and auricle skin 2 cases (4.89%). Tumors were classified according to TNM system: T1 stage 31 cases (75.61 %),T2 stage 10 cases (24.39% ) ,T4 stage 1 case (2.44%) .Result: male-to-female ratio, 1:1.41, there was significant difference between the incidence of males and females (p<0.01). 55-74 years range was in high morbidity, the most affected site was nose (31.7%), the proportion of BCC on the most exposed parts (nose, scalp, periorbital, perioral, and cheek skin) accounted for about 95.2% of all lesions combined. In patients who received operation, the difference of the positive rates between 0.3cm and 0.5cm of surgical margin of the Tl stage tumor was significant (p<0.05). Of all the 41 patients, 4 patients were found regional lymph nodes metastasis or local bone devastation at primary administration (9.76%). Three of patients ( 7.31%) had a second BCC.Conclusion: The morbidity in elder female is higher than that of male at the same age. For tumors smaller than 2cm in diameter, surgical margin of 0.5cm is enough.