Surgical treatment of basal cell carcinomas of the face

The present investigation reviews the history of 673 patients having undergone surgical treatment for 1301 BCC of the face between 1977 and 1992 at our department. Based on this series the features with bearing on the surgical strategy, such as type, size and location of the lesions, will be outlined. Emphasis is put on the variants of local flap reconstruction and skin grafting techniques, particularly in the problem zones of the nose and eyelids, where no excess skin for closure of the defect is available. Throughout the whole series histologic control of the adequacy of marginal and deep tumor resection was performed. It became obvious that the required ranges for clearance to tumor edges and removal in depth cannot be predefined arbitrarily or on pure clinical judgement. Frequently a two-stage procedure of resection and repair will be necessitated. Recurrences during the mandatory follow-up were thoroughly reassessed to identify the reason for failure (e. g. accuracy of histologic category, multifocal growth, predisposition) and related to the time span from primary excision. Our series confirms that morphologically controlled surgical excision of the BCC of the face and subsequent application of reconstructive techniques produces both safe oncologic and esthetic results.