Presurgical Curettage Improves Accuracy for Nonmelanoma Skin Cancer Excision

2019 ◽  
Vol 23 (6) ◽  
pp. 617-623
Author(s):  
Matthew J. Lin ◽  
Danielle P. Dubin ◽  
Cerrene N. Giordano ◽  
Hooman Khorasani ◽  
David A. Kriegel
Keyword(s):  
Skin Cancer ◽  
Frozen Section ◽  
Normal Skin ◽  
Surgical Margin ◽  
Nonmelanoma Skin Cancer ◽  
Skin Cancers ◽  
Frozen Section Analysis ◽  
Skin Cancer Surgery ◽  
Nonmelanoma Skin Cancers ◽  
Section Analysis

Background Presurgical curettage before nonmelanoma skin cancer surgery may help delineate tumor subclinical extensions. Objective To determine histologically whether presurgical curettage appropriately or inappropriately changes excision specimen size. Materials and Methods One hundred fifty consecutive nonmelanoma skin cancers treated with Mohs micrographic surgery. The clinical margin (CM) was marked. Presurgical curettage was then performed and the resultant presurgical curettage margin (PCM) marked. Frozen section analysis of the CM and PCM revealed whether the curettage-induced margin change was appropriate or unnecessary. Results Presurgical curettage appropriately increased the surgical margin in 9.3% of cases, reducing the number of Mohs stages from 2 to 1. It appropriately decreased the surgical margin in 17.3% thereby conserving normal skin. In 19.4% of cases the curettage increased the margin in situations where the CM had underestimated the size of the tumor; however, in these cases, the curettage did not increase the margin sufficiently to clear the tumor. In 44.0% of cases the PCM did not change the size of the stage I specimen compared to the CM and confirmed the CM. In 10.0% of cases, preoperative curettage reduced margin accuracy by removing healthy tissue (8.0%) or underestimating tumor (2.0%). These errors were associated with eyelid location, severe background photodamage, and morpheiform/infiltrating/sclerosing basal cell carcinomas. Conclusion Presurgical curettage can improve tumor excision accuracy and efficiency. Careful tumor selection is important to optimize curette utility.

Intraoperative Frozen Section Analysis for the Excision of Nonmelanoma Skin Cancer: A Single-Center Experience

2019 ◽  
Vol 85 (12) ◽  
pp. 1397-1401
Author(s):  
Tylert Bilden ◽  
Katherine C. Benedict ◽  
Patrick W. Lamb ◽  
Jaron Mcmullin
Keyword(s):  
Skin Cancer ◽  
Predictive Value ◽  
Frozen Section ◽  
False Negative ◽  
Surgical Excision ◽  
Nonmelanoma Skin Cancer ◽  
Intraoperative Frozen Section ◽  
Frozen Section Analysis ◽  
Delayed Reconstruction ◽  
Section Analysis

Surgical resection of nonmelanoma skin cancer (NMSC) may be performed via Mohs micrographic surgery (MMS) or standard surgical excision with complete margin analysis. Whereas MMS may necessitate delayed reconstruction surgery, intraoperative frozen section analysis (IFSA) may be used to ensure clear surgical margins before proceeding with reconstruction. To achieve curative resection while optimizing aesthetic outcomes, surgeons may use surgical excision guided by IFSA to forego extensive or delayed reconstruction. Patients undergoing wide local excision for NMSC using IFSA from October 2008 to November 2016 were evaluated. Analysis included IFSA versus permanent section outcomes, the number of required excisions, and the recurrence rate. Our analysis contained 145 patients involving 162 lesions. IFSA demonstrated that 73.4 per cent of margins were negative after one excision and 26.5 per cent were re-excised until achieving negative margins. Analysis revealed one false-positive case (0.62%) and four false-negative cases (2.47%). Nine patients had local recurrence (5.56%). Frozen section sensitivity was 88.99 per cent and specificity 99.20 per cent. The positive predictive value was 96.97 per cent, and negative predictive value was 96.90 per cent. Mean follow-up time was 39 months. Both resection and recurrence data of excised NMSC lesions at our institution suggest that surgical excision using IFSA is a safe and effective alternative to MMS.

Frozen Section Analysis in the Management of Skin Cancers

1999 ◽  
Vol 43 (2) ◽  
pp. 156-160 ◽  
Author(s):  
Rana R. Ghauri ◽  
Amelia A. Gunter ◽  
Robert A. Weber
Keyword(s):  
Frozen Section ◽  
Skin Cancers ◽  
Frozen Section Analysis ◽  
Section Analysis

scholarly journals Nonmelanoma skin cancer in the population of the city of Belgrade in the period 1999-2011

2015 ◽  
Vol 143 (5-6) ◽  
pp. 290-295 ◽  
Author(s):  
Goran Videnovic ◽  
Dragan Miljus ◽  
Danijela Ilic ◽  
Dragan Krasic ◽  
Snezana Zivkovic
Keyword(s):  
Skin Cancer ◽  
Incidence Rate ◽  
Squamous Cell ◽  
Basal Cell ◽  
Nonmelanoma Skin Cancer ◽  
Skin Carcinoma ◽  
Skin Cancers ◽  
Nonmelanoma Skin Cancers ◽  
The City ◽  
Squamous Cell Skin Carcinoma

Introduction. Nonmelanoma skin cancers in the literature are mainly related to basal cell and squamous cell skin carcinoma. Objective. The aim of the study was to determine the trend in the incidence of histological types of nonmelanoma skin cancers in the population of the city of Belgrade from 1999 to 2011. Methods. From the Serbian National Cancer Registry we extracted all recorded cases of skin cancer in Belgrade from January 1st 1999 to December 31st 2011. Incidence rates were standardized by the method of direct standardization with the world population as the standard population. Trends and annual percentage change (APC) of incidence rate were calculated by performing joinpoint regression analyses. Results. Incidence rate of nonmelanoma skin cancer showed significantly increasing trend between 1999 and 2006 with APC of 8.6% (95% CI: 5.6-11.7), basal cell carcinoma increased with APC of 8.4% (95% CI: 5.2-11.6) and squamous cell skin carcinoma with APC of 9.33% (95% CI: 5.7-13.1). The incidence increased with age for both men and women, especially after the age of 60. Conclusion. Our results showed a continuously increasing incidence trend of both basal cell and squamous cell skin carcinomas in the population of the city of Belgrade between 1999 and 2011. Adequate primary and secondary prevention would certainly be successful in reducing this type of cancer in the future.

Frozen Section Analysis in the Management of Skin Cancers

1999 ◽  
Vol 43 (2) ◽  
pp. 156-160
Author(s):  
Rana R. Ghauri ◽  
Amelia A. Gunter ◽  
Robert A. Weber
Keyword(s):  
Frozen Section ◽  
Skin Cancers ◽  
Frozen Section Analysis ◽  
Section Analysis
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