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Dermatol Surg ; 47(2): 184-188, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32932269

RESUMEN

BACKGROUND: The primary endpoint for surgical excision of skin cancer is the positive margin status. Tumor characteristics may explain much of this risk, but other important factors can include physician specialty. OBJECTIVE: To determine the variables affecting the success of a basal cell carcinoma (BCC) or melanoma in situ (MIS) excision. METHODS/MATERIALS: An 8-year, multicenter, retrospective study of 5,800 BCC or MIS excisions performed at 13 different Kaiser Permanente medical centers. The margin status was determined by searching final pathology diagnosis texts for phrases associated with positive margins. RESULTS: An incomplete excision rate was found in 23% of all specimens (BCC-22%, MIS-25%). Per specialty, the proportion of specimens with positive tumor margins was 24% for dermatology, 26% for plastic surgery, 28% for otolaryngology, and 12% for general surgery. General surgeons most often excised large tumors and tumors from truncal regions, 2 variables conferring lower odds of an incomplete excision. For non-Mohs procedures, dermatologists were no different than otolaryngologists or plastic surgeons in performing an incomplete BCC or MIS excision in all multivariate models (all p > .05). CONCLUSION: Intrinsic tumor characteristics may influence the success of achieving tumor-free resection margins more than the specialty of the provider.


Asunto(s)
Carcinoma Basocelular/cirugía , Márgenes de Escisión , Melanoma/cirugía , Neoplasias Cutáneas/cirugía , Piel/patología , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/patología , Femenino , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Estudios Retrospectivos , Neoplasias Cutáneas/patología , Resultado del Tratamiento
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