Comparison of Tumor Recurrence Rates After Surgical Excision and Mohs Micrographic Surgery for Facial Basal Cell Carcinoma

An-Chen ChenChen ZhengQichao Jian^*Peng Zhang^*

• Huangshi Central Hospital, Huangshi, China

Background:Basal cell carcinoma (BCC), the most prevalent skin cancer, is increasingly common worldwide, impacting facial aesthetics and quality of life. BCC is more frequently observed in Caucasians, while it is relatively rare in Asian populations. Traditional surgical excision, though effective, often leads to high recurrence rates. Mohs micrographic surgery (MMS) may lower recurrence rates, but there is limited data comparing the effectiveness of these two methods for treating facial BCC, especially in Chinese cohorts. This retrospective study from a single Chinese center aims to evaluate how surgical excision and MMS compare in lowering the recurrence rates of tumors after treating facial basal cell carcinoma. Objective: The purpose of this study is to evaluate how surgical excision and MMS compare in lowering the recurrence rates of tumors after treating facial basal cell carcinoma. Methods: This retrospective cohort study included 150 patients with facial BCC who underwent surgical treatment at our dermatology department from October 2018 to October 2023. All patients were divided into two groups based on the surgical method: the surgical excision group (75 patients) and the MMS group (75 patients). All patients were followed for at least 12 months to monitor for tumor recurrence. Results: During the median follow-up period of 45 months (range, 12 to 60 months), the recurrence rate in the MMS group was 2.7% (2/75), compared to 12.0% (9/75) in the surgical excision group, with the MMS group showing a significantly lower recurrence rate (P<0.05). Further analysis indicated that surgical method, tumor diameter greater than 1.5 cm, high-risk pathological types such as infiltrative BCC, multiple lesions, and age over 75 years were the main risk factors for recurrence. Conclusion: In summary, this study shows that MMS significantly lowers tumor recurrence and enhances quality of life compared to traditional surgery for facial basal cell carcinoma. Key recurrence risk factors include age over 75, infiltrative subtype, lesions larger than 1.5 cm, multiple lesions, and traditional surgery. These insights are valuable for clinical practice and treatment strategies for facial BCC.