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Elsevier BV EJC Skin Cancer 4
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    초록·키워드

    <h2>Abstract</h2><h3>Background</h3> Cutaneous basal cell and squamous cell carcinomas are primarily treated with surgical excision. UK guidelines designate histopathological margins of R0+≥1mm as "clear", R0+<1mm as "close" and R1 as "involved". Close/involved margins confer "high-risk" status, mandating multi-disciplinary team review for consideration of further intervention. We aimed to elucidate long-term outcomes of BCCs and SCCs with close and/or involved margins at primary excision compared to clear margins. <h3>Methods</h3> 694 BCCs and 296 SCCs, median follow-up 3 and 16 months, respectively, at a UK University Hospital. All lesions excised with predetermined margins and subsequent management guided by MDT. Survival analysis and multiple logistic regression employed to study outcomes by margin status at excision. <h3>Results</h3> In 694 BCCs, 539 (77.7%) were clear at both deep and peripheral margins, 127 (18.3%) had a single close/involved margin, and 28 (4.0%) were close/involved at both margins. Of BCCs with close/involved margin(s), 123/155 (79.3%) had no further intervention. BCCs with a single close/involved margin had no increased risk of local recurrence compared to lesions with clear margins (HR 1.23,95%CI [0.41-3.72]). In 296 SCCs, 208 (70.3%) were clear at both margins, 63 (21.3%) had close margin(s), and 25 (8.4%) had involved margin(s). Of SCCs with close margin(s), 43/88 (48.8%) had no further intervention. Lesions with close margin(s) had no increased risk of local recurrence compared to lesions with clear margins (HR 1.39,95% CI [0.49-3.94]). <h3>Conclusions</h3> BCCs and SCCs with low tumour burden at the margins managed by MDT have long-term recurrence risk similar to lesions with clear margins.

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