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Effect of Biopsy Technique on Regression Rates in Nonmelanotic Skin Cancer
Nosrati N, Han J, Flores R, Munshi I, Sood R, Tholpady S
Indiana University
2014-03-13
Presenter: Naveed Nosrati
Affidavit:
Study was initiated and written by resident. Study was conducted by resident and student.
Director Name: Rajiv Sood
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Non melanoma skin cancers (NMSC) are the most prevalent type of malignancy with about 3.5 million new cases annually. Diagnosis is confirmed with biopsy and treated with various medical and surgical methods. When the lesion is excised though, there is often no evidence of residual carcinoma, indicating the lesion has regressed. In this study we analyzed what factors during biopsy affect regression.
IRB approval was obtained and a database was constructed of all the NMSC that were biopsied and subsequently excised from 2003-2013 at the Roudebush VAMC. Data collected included lesion characteristics, biopsy type and size, and post biopsy treatments as well as patient demographics. Results were analyzed using the Wilson score interval with a confidence of 95%.
There were 373 lesions identified that contained complete biopsy data. BCC regressed 27% compared to 51% of SCC with an overall average of 38%. Regression rate increased as the ratio of biopsy size to lesion size increased, though a ratio of 1.0 led to the highest rate in SCC. Overall lesions of 6-9 millimeters had the highest regression rates, with the SCC regressing 76% of the time. Biopsy ratios of less than 0.5 regressed only 8% of the time.
In other studies we have shown that certain patient co-morbidities and characteristics affect regression rates. In this study, we have shown that how the lesion is first insulted can also impact regression. With this data we are creating an algorithm to determine which lesions are likely to regress and can thus be observed.
