Retrospective chart review of skin cancer presence in the wide excisions.

AIM To investigate cancer cell absence or presence in wide excision after biopsy of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) patients. METHODS 200 patients (100 BCC and 100 SCC) from the same dermatology clinic, who had positive margin upon biopsy, were selected from a computer generated randomized report. All selected patients had wide excision following biopsy. To determine the correlation of gender, age distribution and cancer absence, BCC and SCC cases were separated based on excision-cancer absent or present after wide excision. χ(2) tests, Fisher's exact tests were used to analyze the ratio of male to female between excision-cancer absent and excision-cancer present patients, while Mann-Whitney U test were used to compare the age distribution in the two groups. Statistical analyses were performed using SPSS version 16.0 for Windows. RESULTS Our retrospective chart review of the patients showed that cancer cells were absent in 49% of BCC patients (n = 100) and 64% of SCC patients (n = 100) who had previously had positive margins upon biopsy. Gender analysis showed the ratio of male to female (M/F) in the BCC arm was significantly higher compared with the SCC arm in those with excision-cancer absent (2.06 vs 0.66; P = 0.004; χ(2) test). But M/F of excision-cancer absent and excision-cancer present in neither BCC nor SCC patients was statistically significant. Age adjustment showed no significant difference between excision-cancer absent and excision-cancer present in BCC and SCC patients. Nevertheless, in excision-cancer absent cases, the age distribution showed that the BCC patients were younger than SCC patients (average age 67 vs 74; P < 0.001; Mann-Whitney U test). In addition, our data also indicated that in the patient group of 71-80 years old, there were more SCC patients who showed excision-cancer absence (67.6% vs 39.4%; P = 0.02; χ(2) test). CONCLUSION Our study indicates that approximately 50% or more of BCC and SCC patients with positive margins found on biopsies did not have cancer cells present at the time of wide excisions.

[1]  J. Carucci,et al.  Understanding Dendritic Cells and Their Role in Cutaneous Carcinoma and Cancer Immunotherapy , 2013, Clinical & developmental immunology.

[2]  R. Brodell,et al.  The Art and Science of Surgical Margins for the Dermatopathologist , 2012, The American Journal of dermatopathology.

[3]  G. Goldman,et al.  Mohs Surgery Is Effective for High‐Risk Cutaneous Squamous Cell Carcinoma , 2010, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[4]  J. Carucci,et al.  Myeloid dendritic cells from human cutaneous squamous cell carcinoma are poor stimulators of T-cell proliferation. , 2009, The Journal of investigative dermatology.

[5]  David A. Lee,et al.  Nonmelanoma skin cancer. , 2009, Facial plastic surgery clinics of North America.

[6]  Lisa C. Zaba,et al.  Resident and "inflammatory" dendritic cells in human skin. , 2009, The Journal of investigative dermatology.

[7]  C. Ko,et al.  Langerhans cells in squamous cell carcinoma vs. pseudoepitheliomatous hyperplasia of the skin , 2007, Journal of cutaneous pathology.

[8]  F. Giorlando,et al.  Incomplete Excision of Squamous Cell Carcinoma of the Skin: A Prospective Observational Study , 2007, Plastic and reconstructive surgery.

[9]  C. Aspord,et al.  Breast cancer instructs dendritic cells to prime interleukin 13–secreting CD4+ T cells that facilitate tumor development , 2007, The Journal of experimental medicine.

[10]  D. Selva,et al.  Scalp Tumors Treated with Mohs Micrographic Surgery: Clinical Features and Surgical Outcome , 2006, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[11]  H. Moutsopoulos,et al.  Wound healing: immunological aspects. , 2006, Injury.

[12]  S. Saeland,et al.  Cutaneous dendritic cells. , 2005, Seminars in immunology.

[13]  D. Gabrilovich.  Mechanisms and functional significance of tumour-induced dendritic-cell defects , 2004, Nature Reviews Immunology.

[14]  A. Barbul,et al.  Understanding the role of immune regulation in wound healing. , 2004, American journal of surgery.

[15]  C. Figdor,et al.  Dendritic cell immunotherapy: mapping the way , 2004, Nature Medicine.

[16]  J. Belisle,et al.  Langerhans cells utilize CD1a and langerin to efficiently present nonpeptide antigens to T cells. , 2004, The Journal of clinical investigation.

[17]  Christophe Caux,et al.  Tumour escape from immune surveillance through dendritic cell inactivation. , 2002, Seminars in cancer biology.

[18]  G. Hoffmann,et al.  Nitric oxide-dependent apoptosis in ovarian carcinoma cell lines. , 2001, Gynecologic oncology.

[19]  J. Banchereau,et al.  IL-6 switches the differentiation of monocytes from dendritic cells to macrophages , 2000, Nature Immunology.

[20]  J. Mcgregor,et al.  Cytokines secreted by lymphokine-activated killer cells induce endogenous nitric oxide synthesis and apoptosis in DLD-1 colon cancer cells. , 2000, Cellular immunology.

[21]  W. Hiddemann,et al.  Induction of inducible nitric oxide synthase is an essential part of tumor necrosis factor-alpha-induced apoptosis in MCF-7 and other epithelial tumor cells. , 1999, Laboratory investigation; a journal of technical methods and pathology.

[22]  L. Arnould,et al.  Nitric oxide synthase in human breast cancer is associated with tumor grade, proliferation rate, and expression of progesterone receptors. , 1999, Laboratory investigation; a journal of technical methods and pathology.

[23]  W. Hiddemann,et al.  Caspase-activation and induction of inducible nitric oxide-synthase during TNF alpha-triggered apoptosis. , 1999, Anticancer research.

[24]  A. O'Grady,et al.  Langerhans cells in benign, premalignant and malignant skin lesions of renal transplant recipients and the effect of retinoid therapy , 1998, Journal of the European Academy of Dermatology and Venereology : JEADV.

[25]  A. Enk,et al.  Induction of tolerance by IL-10-treated dendritic cells. , 1997, Journal of immunology.

[26]  L. DiPietro,et al.  WOUND HEALING: THE ROLE OF THE MACROPHAGE AND OTHER IMMUNE CELLS , 1995, Shock.

[27]  Robin Marks,et al.  An overview of skin cancers , 1995, Cancer.

[28]  K. Fleming,et al.  Langerhans' cells and T cells in human skin tumours: an immunohistological study , 1984, Histopathology.