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<p>Skin cancers are routinely excised in dermatologic practice. Due to limitations within some centers around the world, clinicians use a clinical diagnosis rather than histology for excisional planning. An incomplete excision can have multiple consequences depending on the lesion excised. Our objective in this study is to determine which clinical factors can influence incomplete excision of a lesion. A single-center, retrospective, descriptive study was performed. 3638 excisions were performed between 2016 and 2022. Biopsies, non-malignant, and incompletely documented cases were excluded resulting in 106 cases with positive margins and 959 with negative margins. Several factors increased the risk of positive margins: Patients living in rural areas (<i>p</i> = 0.033), diagnosis uncertainty (<i>p</i> = 0.004), surgical experience of physicians (<i>p</i> = 0.011), tumors with increased thickness (<i>p</i> &lt; 0.001), tumors localized on the face (<i>p</i> &lt; 0.001), and ulcerations were more common for patients with incompletely excised tumors (<i>p</i> &lt; 0.001). Number of excisions on day of surgery, tumor thickness, ulceration, patient distance from healthcare providers, and diagnostic uncertainty may contribute to positive margins on malignant excisions. Preoperative understanding and evaluation of these factors may help improve the rate of complete excisions.</p>

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Factors contributing to incomplete excision of clinically diagnosed nonmelanoma and melanoma skin cancer: a single center retrospective review

  • 期刊论文

  • 发表日期：

    2025年10月11日

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  • Nicholas Florin Kormos,
  • Stanislav N. Tolkachjov,
  • Umer Nadir,
  • Carina Petrenciu,
  • Iulia Corina Cotrîlă,
  • Ana Maria Mureșan Bădescu,
  • Ioana Daria Paval,
  • Adrian Baican

摘要

Skin cancers are routinely excised in dermatologic practice. Due to limitations within some centers around the world, clinicians use a clinical diagnosis rather than histology for excisional planning. An incomplete excision can have multiple consequences depending on the lesion excised. Our objective in this study is to determine which clinical factors can influence incomplete excision of a lesion. A single-center, retrospective, descriptive study was performed. 3638 excisions were performed between 2016 and 2022. Biopsies, non-malignant, and incompletely documented cases were excluded resulting in 106 cases with positive margins and 959 with negative margins. Several factors increased the risk of positive margins: Patients living in rural areas (p = 0.033), diagnosis uncertainty (p = 0.004), surgical experience of physicians (p = 0.011), tumors with increased thickness (p < 0.001), tumors localized on the face (p < 0.001), and ulcerations were more common for patients with incompletely excised tumors (p < 0.001). Number of excisions on day of surgery, tumor thickness, ulceration, patient distance from healthcare providers, and diagnostic uncertainty may contribute to positive margins on malignant excisions. Preoperative understanding and evaluation of these factors may help improve the rate of complete excisions.