Manejo quirúrgico del carcinoma basocelular basado en tres grupos de riesgo. Experiencia en un centro de tercer nivel de Colombia, 2008-2010.

BACKGROUND: Basal cell carcinoma is the most frequent skin cancer; it has been classically classified into two groups of recurrence risk for its management. OBJECTIVES: To describe the characteristics of primary tumors managed by conventional surgery, according to institutional guidelines, describing the findings of tumors with positive margins or recurrences and analyzing the associated factors. MATERIALS AND METHODS: A retrospective descriptive study was carried out seeking the relationship between margin compromise and tumor recurrence, with the risk classification used in the National Institute of Cancerology of Colombia, by comparing the demographic, clinical and histological parameters of the tumors managed with conventional surgery from 2008 to 2010 with the previously mentioned outcomes. Recurrence free survival was determined using the Kaplan-Meier method. RESULTS: 429 tumors were surgically removed in 335 patients, obtaining free margins in 96.5% of resections based on the three-risk group approach. Of those with positive margins, 12 belonged to the high risk group, 3 to the medium risk group and none to the low risk group. Five recurrences occurred, 3 in the high risk group and two in the medium one, with a median occurrence of 11 months. CONCLUSIONS: The classification with three risk groups allows the adequate management of basal cell carcinoma, with little persistence and tumor recurrence, allowing to decrease the need of Mohs micrographic surgery or excessive tissue removal. [ABSTRACT FROM AUTHOR]