FC21 Clinical, histological and demographic predictors for recurrence and second primary tumour of head and neck basal cell carcinoma. A 1062 patient-cohort study from a tertiary cancer referral hospital

Background Basal cell carcinoma (BCC) accounts for nearly 25% of all cancers in the human body and for almost 75% of skin malignancies; approximately 85% of basal cell carcinomas develop in the head and neck region. Limited demographic, clinical and histological predictors for second primary and/or recurrent BCC have been identified to date.

Objective To identify predictors of recurrence and second primary tumour development of BCC in the head and neck region.

Methods and materials We included 1062 patients with a histological confirmed diagnosis of BCC. Multivariate and Cox regression analysis were used to access demographic, clinical and histological predictors.

Results Study follow up included 4302 patient-years, each patient was followed-up for an average 4.0±1.8 years (range 1–12). Overall recurrence rate was 4%. High-risk histology type was associated with increased risk for recurrence [odds ratio (OR)=3.47, 95% CI: 1.07–11.25]. We calculated a 4-fold increased risk for recurrence with positive excision margins (OR=4.31, 95% CI: 1.82–10.22), a 21% increased risk for recurrence (OR=1.21, 95% CI: 1.06–1.37) and a 25% increased risk for second primary BCC development (OR=1.25, 95% CI: 1.17–1.34) per every single year of follow-up. The median free of second primary tumour time was 7 years, while the median free of recurrence time was 12 years.

Conclusion The strongest predictors for recurrence are positive excision margins and high-risk histology type, indicating the need for additional patient care in such cases.