www.sbdmj.com - Stomatologija - Baltic Dental and Maxillofacial Journal

Stomatologija 2020; 22 (1): 9-16 378 KB

Basal Cell Carcinoma. Analysis of 395 cases localized in the neck, ear and nose region

Egils Kornevs^1,2, Ingus Arnolds Apse^3,4, Toms Janis Safronovs³, Aija Krastina⁶, Arturs Paparde⁵, Gunars Lauskis^1,2, Girts Salms^1,7

Summary

Background and objectives. To test if there are different outcomes in basal cell carcinoma for lesion size, histopathology, localization, and recurrence rates.

Materials and methods. A total of 395 patients with BCC localized in the neck, nose and ear regions who were surgically treated in Latvian Oncology Centre between 2006-2011 were analyzed retrospectively. The data were analyzed using modified classification based on Clarks et al. (2014) and McKenzie et al. (2016).

Results. Three hundred and ninety-five cases of BCC that were surgically treated in head and neck region were reviewed. Results were tabulated in four categories: anatomical region, histopathology, lesion size, and recurrence rates. Classification by anatomical region: 228 cases in the nose region, 82 cases in the neck region, 82 cases in the ear region. Classification by histopathology: 259 cases presented as low risk BCC [nodular, pigmented, adenoid, keratotic and cystic], 21 cases presented as superficial, 94 cases presented as mixed, and 21 cases presented as high-risk BCC (metatypical, morphea form). Mann-Whitney U test was used to compare recurrent BCC cases to non-recurrent cases. Significantly higher recurrence rates were observed if BCC at the time of the excision was ≥ 10mm (p<0.001). Significance was also noted in cases where histopathology was mixed BCC and in cases where mixed BCC was localized to the nose region (p<0.001).

Conclusion. More attention should be brought to assessing classification and clinical treatment synergy. Higher recurrence rates are observed when lesions occur in high risk anatomical region (H zone), when lesion size reaches or exceeds 20 mm in diameter, and when lesion is subtyped as mixed BCC. It is crucial to evaluate risk factors such as BCC subtype and localization, as these are associated with a higher rate of recurrence when present in a single lesion. These risk factors, together with pre-treatment lesion evaluation will enable formulation of better treatment plan and prognostic aspects in each case.

Key words: basal cell carcinoma, recurrence, head and neck oncology, non-melanoma skin cancer.

Received: 17 12 2019

Accepted for publishing: 21 03 2020

¹Department of Oral and Maxillofacial Surgery, Riga Stradiņš University, Riga, Latvia

²Department of Head and Neck surgery, Oncology Centre of Latvia, Riga East Clinical University Hospital, Riga, Latvia

³Faculty of Medicine, Riga Stradiņš University, Riga, Latvia

⁴Faculty of Dentistry, Riga Stradiņš University, Riga, Latvia

⁵Department of Human physiology and biochemistry, Riga Stradiņš University, Riga, Latvia

⁶Department of Anesthesiology and Intensive Therapy, Oncology Centre of Latvia, Riga East Clinical University Hospital, Riga, Latvia

⁷Department of Maxillofacial Surgery, Oncology Centre of Latvia, Riga East Clinical University Hospital, Riga, Latvia

Address correspondence to Ingus Arnolds Apse, Department of Oral and Maxillofacial Surgery, Riga Stradiņš University, Riga, Latvia.

E-mail: apseingus@gmail.com



	Baltic Dental and Maxillofacial Journal

March, 2020, Vol. 22, No. 1 CONTENTS SCIENTIFIC ARTICLES Tendencies of FGFR2 rs2981582 polymorphism in patients with oral cancer Vykintas Liutkevicius, Toma Tamauskaite, Alvita Vilkeviciute, Rasa Liutkeviciene, Rasa Smalinskaite, Agne Giedraitiene, Alina Smalinskiene, Virgilijus Uloza 3-8 REVIEWS Basal Cell Carcinoma. Analysis of 395 cases localized in the neck, ear and nose region Egils Kornevs, Ingus Arnolds Apse, Toms Janis Safronovs, Aija Krastina, Arturs Paparde, Gunars Lauskis, Girts Salms 9-16 Sodium hypochlorite accidents in dentistry. A systematic review of published case reports Shishir Ram Shetty, Sura Ali Ahmed Fuoad Al-Bayati, Ashwin Narayanan, Mohammed Said Hamed, Hossam Abdelatty Eid Abdemagyd, Praveen Shetty 17-22 Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw Henrikas Rusilas, Aušra Balčiūnaitė, Juozas Žilinskas 23-27 CASE REPORT Clear cell odontogenic carcinoma: a rare pathology with an innovative resolution Natalia Lucía Gómez, Luis Boccalatte, Alejandro Yanzón, María Gabriela Nassif, Juan José Larrañaga, Marcelo Fernando Figari 28-32 © 2020 Stomatologija		Stomatologija 2020; 22 (1): 9-16 378 KB Basal Cell Carcinoma. Analysis of 395 cases localized in the neck, ear and nose region Egils Kornevs^1,2, Ingus Arnolds Apse^3,4, Toms Janis Safronovs³, Aija Krastina⁶, Arturs Paparde⁵, Gunars Lauskis^1,2, Girts Salms^1,7 Summary Background and objectives. To test if there are different outcomes in basal cell carcinoma for lesion size, histopathology, localization, and recurrence rates. Materials and methods. A total of 395 patients with BCC localized in the neck, nose and ear regions who were surgically treated in Latvian Oncology Centre between 2006-2011 were analyzed retrospectively. The data were analyzed using modified classification based on Clarks et al. (2014) and McKenzie et al. (2016). Results. Three hundred and ninety-five cases of BCC that were surgically treated in head and neck region were reviewed. Results were tabulated in four categories: anatomical region, histopathology, lesion size, and recurrence rates. Classification by anatomical region: 228 cases in the nose region, 82 cases in the neck region, 82 cases in the ear region. Classification by histopathology: 259 cases presented as low risk BCC [nodular, pigmented, adenoid, keratotic and cystic], 21 cases presented as superficial, 94 cases presented as mixed, and 21 cases presented as high-risk BCC (metatypical, morphea form). Mann-Whitney U test was used to compare recurrent BCC cases to non-recurrent cases. Significantly higher recurrence rates were observed if BCC at the time of the excision was ≥ 10mm (p<0.001). Significance was also noted in cases where histopathology was mixed BCC and in cases where mixed BCC was localized to the nose region (p<0.001). Conclusion. More attention should be brought to assessing classification and clinical treatment synergy. Higher recurrence rates are observed when lesions occur in high risk anatomical region (H zone), when lesion size reaches or exceeds 20 mm in diameter, and when lesion is subtyped as mixed BCC. It is crucial to evaluate risk factors such as BCC subtype and localization, as these are associated with a higher rate of recurrence when present in a single lesion. These risk factors, together with pre-treatment lesion evaluation will enable formulation of better treatment plan and prognostic aspects in each case. Key words: basal cell carcinoma, recurrence, head and neck oncology, non-melanoma skin cancer. Received: 17 12 2019 Accepted for publishing: 21 03 2020 ¹Department of Oral and Maxillofacial Surgery, Riga Stradiņš University, Riga, Latvia ²Department of Head and Neck surgery, Oncology Centre of Latvia, Riga East Clinical University Hospital, Riga, Latvia ³Faculty of Medicine, Riga Stradiņš University, Riga, Latvia ⁴Faculty of Dentistry, Riga Stradiņš University, Riga, Latvia ⁵Department of Human physiology and biochemistry, Riga Stradiņš University, Riga, Latvia ⁶Department of Anesthesiology and Intensive Therapy, Oncology Centre of Latvia, Riga East Clinical University Hospital, Riga, Latvia ⁷Department of Maxillofacial Surgery, Oncology Centre of Latvia, Riga East Clinical University Hospital, Riga, Latvia Address correspondence to Ingus Arnolds Apse, Department of Oral and Maxillofacial Surgery, Riga Stradiņš University, Riga, Latvia. E-mail: apseingus@gmail.com