Poster Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

Aggressive histological subtypes of BCC have higher rates of incomplete excision on the head and neck (1417)

Tom Whitton 1 , Sid Karanth 1
  1. Plastic and Reconstructive Surgery, Royal Hobart Hospital, Hobart, Tasmania, Australia

Purpose: Non-melanoma skin cancer (NMSC) are the most common cancers in Australia and worldwide, occurring predominantly on sun exposed areas of the head and neck.  Of these, basal cell carcinoma (BCC) is most common (1).  Surgical excision remains the mainstay of treatment, however the challenges of maintaining function and cosmesis without tissue surplus are particularly vital in the head and neck.  The rates of incomplete excision are known to vary between low and high-risk histological subtypes (2).  Our aim is to reduce the rates of incomplete excision by analysing the associated risk factors.


Methodology: A review was undertaken of patients undergoing surgical excision of a head and neck BCC between 2015-2020 at the Plastic and Reconstructive Surgery Unit of the Royal Hobart Hospital, Tasmania, Australia.  This study was approved by the Human Research Ethics Committee of Tasmania (H0018554)


Results: During the study period, 1009 BCC were excised from the head and neck.  Of these, 9.8% were incompletely excised.  When compared to nodular, infiltrative (OR: 2.44, p 0.005), sclerosing (morphoeic) (OR: 3.07, p <0.001), micronodular (OR: 3.9, p <0.001), and basosquamous (OR: 6.7, p <0.002) were all significantly more likely to be incompletely excised.


Conclusion: High-risk histological subtypes of BCC are more likely to incompletely excised than low risk lesions, and as such, great care should be taken when excising high-risk lesions.

  1. Alam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med. 2001;344(13):975-83.
  2. Bernardini N, Skroza N, Zuber S, Tolino E, Balduzzi V, Mambrin A, et al. Face and Scalp Basal Cell Carcinoma Treatment: A Review of the Literature. Acta Dermatovenerol Croat. 2019;27(1):22-7.
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