P60b Epidemiological trends in non melanoma skin cancer in a Mediterranean population

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Introduction Non melanoma skin cancer (NMSC) is the most common malignancy occurring in the Caucasian race. Sun exposure and advanced age are the most important risk factors in the development of these tumors. Currently, more epidemiological data are needed to determine the true distribution in the Mediterranean population. The objective of this study is to estimate the incidence of histologically proven basal cell carcinoma in a cohort of Spanish patients and to assess the risk of relapse and the time to development of subsequent cutaneous tumors after 10 years of follow-up. Methods Patients were retrospectively studied from 1997 to 2007. Data analysis included sex, age, immune status, tumor location, histology (subtype, vascular and/or neural involvement and status of surgical margins), time to relapse and incidence of new skin tumors during follow-up. Information was collected from histological reports and the clinical database from a tertiary care hospital in Madrid, Spain that serves a population of roughly 750 000 inhabitants in a specific sanitary area. Results We have studied 106 patients with a confirmed diagnosis of basal cell carcinoma, 48 of them (45,3%) were males and 58 (54,7%) females. The median age was 66,25 years old (range 41–91) and the mean size 185,09 mm2. Solid basal cell carcinoma was the most common histological type (41,5%). The most frequent locations were the inferior aspect of the nose (17%), temporal area of the scalp (15%), upper part of the nose (10,4%) and right frontal area of the scalp (7,5%). After conventional surgery, 19 (17,9%), 9 (8,5%) and 3 (2,8%) patients had involvement of a lateral, deep and both margins, respectively. After a mean follow-up of 115 months, we recorded 13 cases of first relapse (12,26%), 6 of them (46,15%) diagnosed before 16,80 months (range 2,59–85,26) and 2 cases of second relapse (1,89%) at 7,20 and 52,10 months. Thirty patients presented a second primary cutaneous tumor, the most frequent one being solid basal cell carcinoma, seen in 11 patients (10,4%), followed by intraepidermal squamous cell carcinoma observed in 7 patients (6,6%). Roughly 50% of the second tumors appeared in the first 37 months (range 3,98–137,33). Immunosuppression was present in 11 patients (10,4%) and 25 (24,5%) were diagnosed of a synchronous or metachronous malignant solid neoplasia. Conclusion We have carried out a cohort study to assess, in addition to the incidence and distribution of basal cell carcinoma, the risk of relapse and the development of new tumors. We have studied a stable population of patients, not biased by hospital referral, during a follow-up time period of 10 years. We provide key epidemiological data on the most common cutaneous malignancy in a Mediterranean population where limited information is currently available.