Retrospective Analysis of the Treatment and Follow-up of 251 Patients with Non-melanoma Skin Cancer in the Mediterranean Region

INTRODUCTION: Non-melanoma skin cancer (NMSC) is the most common type of cancer worldwide. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) constitute 99% of NMSCs, with BCC being 3–5 times more common than SCC. This study analyzed the demographic data, treatment and follow-up of patients with NMSC and compared the results with those of previous studies.
METHODS: Patients who had been followed-up and treated for NMSC by a single surgeon between January 2014 and January 2018 were evaluated retrospectively.
RESULTS: The average age of the 251 patients treated and followed for NMSC was 69.9 years. The incidence of BCC was found to be two times of the SCC. The most frequent tumor localization was the head and neck. Among the head and neck tumors, the incidence of nasal tumors was the highest. Intact surgical margin excisions of 0.5 cm for BCC and 1 cm for SCC were performed. Local flaps were the most common reconstruction option (61.18%). Eleven patients could not be operated on and four of the unoperable tumors were invased to the eye. Positive surgical margins were determined in 4.43% of the patients, but only four patients had disease recurrence during the 25.82 months of follow-up. A new NMSC developed in a different anatomic region in 17 patients. Three of the patients with recurrence died due to NMSC.
DISCUSSION AND CONCLUSION: NMSC is easily diagnosed by physical examination and biopsy is not necessary in every case. The incidence of SCC in our series was higher than reported in previous studies. Local flaps were the preferred reconstruction option. The rates of positive surgical margins (4.27%) and relapse (1.31%) were low. This result can be attributed to adequate depth of the excision from the base through the reconstruction of the defect with flap, and the relatively short (< 5 years) follow-up period.

Akdeniz Bölgesinde Melanom Dýþý Deri Kanserli 251 Olgunun Takip ve Tedavisin Retrospektif Analizi

GÝRÝÞ ve AMAÇ: Melanom dýþý deri kanseri (MDDK) dünya çapýnda en yaygýn kanser tipidir. Bazal hücreli karsinom (BCC; basal cell carcinoma) ve skuamöz hücreli karsinom (SCC; squamous cell carcinoma) MDDK’lerinin % 99’unu oluþturur ve BCC, SCC’dan 3-5 kat sýk görülür. Burada, MDDK nedeniyle takip edilen hastalarýn demografik verileri ve tedavileri, takip sonuçlarý araþtýrýldý ve bunlar fark ve benzerlik açýsýndan daha önceki veriler ile karþýlaþtýrýldý.
YÖNTEM ve GEREÇLER: Retrospektif olarak, 2014 Ocak- 2018 Ocak tarihleri arasýnda, tek cerrah tarafýndan MDDK nedeniyle takip ve tedavisi yapýlan hastalar incelendi.
BULGULAR: Toplam 251 hasta MDDK nedeniyle tedavi ve takip edildi. Hastalarýn ortalama yaþý 69.9’du. BCC insidansý SCC’nin iki katý bulundu. En fazla tümör lokalizasyonu baþ boyun ve baþ boyun bölgesinde de en sýk lokalizasyon burundu. BCC için 0,5 cm, SCC için 1 cm saðlam cerrahi sýnýrla eksizyon yapýldý. Rekonstrüksiyon seçeneði olarak çoðunlukla lokal flepler kullanýldý (%61.18). 11 hasta opere edilemedi ve opere edilemeyen tümörlerin 4 tanesi göze invazeydi. Vakalarýn %4.43’ünde cerrahi sýnýr pozitif olarak rapor edilirken, 25,82 aylýk takipte sadece 4 hastada nüks gözlendi. 17 hastada baþka bir bölgede yeni bir MDDK gözlendi. Nüks olan hastalarýn 3’ü MDDK nedeniyle öldü.
TARTIÞMA ve SONUÇ: MDDK tanýsý fizik muayene ile çok rahat konulabilmektedir. Biyopsi her vakada gerekli deðildir. Burada, SCC oraný önceki çalýþmalardan farklý olarak beklenenden daha fazla bulundu. Tedavide rekonstrüksiyon seçeneði olarak daha çok lokal flepler tercih edildi. Cerrahi sýnýr pozitif hasta sayýsý (%4.27) ve nüks oraný (%1.31) oldukça az bulundu. Bu da, tedavide flep seçeneðinin tercih edilmesine baðlý tabandan yeterli derinlikte eksizyon yapýlmasýna ve takip süresinin 5 yýldan kýsa olmasýna baðlanabilir.