Predictive factors for the recurrence of surgically excised basal cell carcinomas: A retrospective clinical and immunopathological pilot study

Vornicescu,Corina; Șenilă,Simona Corina; Bejinariu,Nona Ionela; Vesa,Ștefan Cristian; Boșca,Adina Bianca; Chirilă,Daciana Narcisa; Melincovici,Carmen Stanca; Sorițău,Olga; Mihu,Carmen Mihaela

doi:10.3892/etm.2021.10771

Predictive factors for the recurrence of surgically excised basal cell carcinomas: A retrospective clinical and immunopathological pilot study

Authors:
- Corina Vornicescu
- Simona Corina Șenilă
- Nona Ionela Bejinariu
- Ștefan Cristian Vesa
- Adina Bianca Boșca
- Daciana Narcisa Chirilă
- Carmen Stanca Melincovici
- Olga Sorițău
- Carmen Mihaela Mihu
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Affiliations: Department of Morphological Sciences‑Histology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400349 Cluj‑Napoca, Romania, Department of Dermatology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400349 Cluj‑Napoca, Romania, Department of Pathology, Santomar Oncodiagnostic, ‘Regina Maria’ Private Healthcare Network, 400664 Cluj‑Napoca, Romania, Department of Pharmacology, Toxicology and Clinical Pharmacology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400337 Cluj‑Napoca, Romania, Department of Surgery, Vth Surgical Clinic, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400139 Cluj‑Napoca, Romania, Laboratory of Tumor Biology and Radiobiology, ‘Prof. Dr. Ion Chiricuţă’ Oncology Institute, 400015 Cluj‑Napoca, Romania
Published online on: September 20, 2021 https://doi.org/10.3892/etm.2021.10771
Article Number: 1336
Copyright: © Vornicescu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Basal cell carcinoma (BCC) is the most frequent form of skin cancer and is not a tumor with a lethal outcome if diagnosed and treated adequately. The gold standard for treatment is surgical excision with histologically safe margins. Even so, tumors excised with free margins may recur after a period of time. The identification of predictive factors for the recurrence of BCCs besides the localization, size and aggressive histology may be useful for the clinician. The aim of the present study was to identify clinical and pathological factors associated with recurrence in tumors with histologically free margins and assess via immunohistochemical staining, the expression of glioma‑associated oncogene homolog 1 (GLI1), yes‑associated protein (YAP), connective tissue growth factor (CTGF) and E‑cadherin as they are involved in the development of BCCs, in the hope of identifying markers that are predictive for recurrence. In total, 8 recurrent BCCs and 38 non‑recurrent tumors were analyzed. A Breslow index >2 (Se 100.0%, Sp 67.5%, P=0.008), Clark level >3 (Se 100.0%, Sp 47.5%, P<0.001), and excision margins both lateral (Se 87.5%, Sp 60.0%, P=0.04) and deep (Se 75.0%, Sp 82.5%, P<0.001) free from tumoral cells ≤1 mm proved to be predictive for recurrence in the present study. Recurrence may appear even after more than 3 years since the initial excision (Se 87.50%, Sp 70.0%, P<0.001). The expression levels of GLI1, YAP and E‑cadherin were not different in the recurrent vs. non‑recurrent BCCs. However, the low expression of CTGF may indicate a tumor with a higher aggressiveness. In conclusion, close follow‑up of patients with excised BCCs at least annually is recommended and re‑excision should be taken into consideration for locally advanced tumors especially if they are located in high‑risk areas or those with histologically free margins <1 mm.

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