Eradication of basal cell carcinoma of the head and neck using the surgical excision with a new stained margin technique: a preliminary study

BACKGROUND: Basal cell carcinomas (BCCs) are common cutaneous neoplasms that mainly affect fair-skinned subjects, in sun-exposed areas of the body. The treatment of choice of BCCs is represented by surgical excision and different techniques are available, in order to allow the complete eradication of the tumor with the best cosmetic results. In this paper, we describe the surgical excision with stained margin technique (SMET) and we report its efficacy for the treatment of BCCs of the head and neck region. METHODS: We retrospectively studied 177 BCCs of the head and neck region treated by SMET: a surgical technique in which each specimen is cut vertically like a bread-loaf in multiple sections of 1 mm of thickness, after marking peripheral margins. RESULTS: We observed an overall recurrence rate of 4.5% after SMET (mean follow-up: 26 months), with higher rate in aggressive subtypes (P=0.04). BCCs located in high-risk sites and those previously undergone to other non-radical therapies required two or more procedures (P=0.008 and P=0.002, respectively), while no correlation was observed between the number of SMET procedures and recurrence rate. CONCLUSIONS: In our experience, since low recurrence rate was obtained by SMET, we suggest that it may be taken into consideration as surgical option for BCCs of the head and neck region.