Management and Clinico-Pathologic Aspects of Non-Melanoma Skin Cancer of the Head and Neck: A Retrospective Institutional Based Study at the Egyptian National Cancer Institute

Ihab Samy Fayek,Dalia Bilal Mohammed,Mohammed Ahmed Rifaat

doi:10.4236/jct.2019.1010072

Abstract

Background: Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 years at the National Cancer Institute—Cairo University—Egypt. Materials and Methods: A retrospective study of two hundred patients with NMSCHN was treated at the National Cancer Institute—Cairo University—Egypt from January 2008 to December 2012. The mean follow-up was 6 months (1 - 84 months). Results: 117 males and 83 females with 90% ≥ 50 years old. The scalp (27.5%), the periorbital region (13%), the cheek (12.5%) and the nose (12.5%) are the main anatomical sites affected. BCC represented 71.5% with nodular type (79%) predominance; SCC represented 21% with GII (61.1%) the commonest grade. Surgery was the main modality of treatment (93%) with local flaps only (63.9%) and primary closure (14.7%) were the main surgical options following wide local excision. Positive and close margins were detected in 23.5% of excised specimens. No significant association was found between disease-free survival (DFS) and pathology, treatment modality, the occurrence of complications or safety margin status. Conclusion: NMSCHN lesions should be surgically excised in specialized high volume centers with readily available peripheral margin control and should be operated by senior experienced surgeons.

Highlights

Non-melanoma skin cancer (NMSC) is the most common malignancy among Caucasians
Materials and Methods: A retrospective study of two hundred patients with NMSCHN was treated at the National Cancer Institute—Cairo University—Egypt from January 2008 to December 2012
No significant association was found between disease-free survival (DFS) and pathology, treatment modality, the occurrence of complications or safety margin status

Summary

Introduction

Non-melanoma skin cancer (NMSC) is the most common malignancy among Caucasians. NMSC principally comprises basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), but includes a host of rarer skin tumors [1]. The incidence of NMSC was addressed at the National Population-Based Cancer Registry Program (2008-2011) as 1.35% of all cancers in males and 1.24% of all cancers in females [4] In settings such as developing countries where Moh’s Micrographic Surgery is not readily available, prediction of NMSC aggressive lesions based on preoperative information (age, immunosuppression status, and location) is critical for surgical planning and for reducing recurrence risk by treating the lesion with sufficiently adequate margins. This study will focus on Egyptian patients with non-melanoma skin cancer of the head and neck (NMSCHN) who presented, diagnosed and managed at the National Cancer Institute—Cairo University—Egypt. Reviewing and analyzing the Clinico-pathologic aspects of non-melanoma skin cancer of the head and neck (NMSCHN), type of management, prognostic factors, and disease-free survival (DFS) in a period of 5 years at the National Cancer Institute—Cairo University—Egypt. Conclusion: NMSCHN lesions should be surgically excised in specialized high volume centers with readily available peripheral margin control and should be operated by senior experienced surgeons

Methods

Results

Conclusion