Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision

Background: One common treatment for Bowen’s disease (BD) is surgical excision, but there is no international consensus on the appropriate surgical margins. Objectives: This study examined what factors affect the rate of incomplete excision of BD. Methods: Clinicopathological data potentially...

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Autores principales:	Julia Fougelberg, Hampus Ek, Magdalena Claeson, John Paoli
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2021
Materias:	Bowen disease dermatological surgery surgical margins nonmelanoma skin cancer Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/5e0d9e3046af4a368b4c69adc25720b3
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spelling	oai:doaj.org-article:5e0d9e3046af4a368b4c69adc25720b32021-11-17T08:27:57ZSurgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision10.5826/dpc.1102a462160-9381https://doaj.org/article/5e0d9e3046af4a368b4c69adc25720b32021-04-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/1553https://doaj.org/toc/2160-9381 Background: One common treatment for Bowen’s disease (BD) is surgical excision, but there is no international consensus on the appropriate surgical margins. Objectives: This study examined what factors affect the rate of incomplete excision of BD. Methods: Clinicopathological data potentially linked to surgical outcome (complete or incomplete excision) were retrospectively collected from medical and histopathological records on all surgically excised BD lesions diagnosed at Sahlgrenska University Hospital in Gothenburg, Sweden during 2014-2015. Data were analyzed with two definitions of incomplete excision: less strict (ie, BD present at the surgical margin) and strict (ie, dysplasia present at the surgical margin). Results: In total, 463 BD lesions among 408 patients were included. With the less strict definition, 3 factors were associated with significantly higher rates of incomplete excision: surgical margins <3 mm, a less experienced surgeon, and use of punch biopsy excision. The same factors plus a tumor location on the head and neck area or upper extremities were associated with significantly higher rates of incomplete excision using the strict definition. After adjustment for confounders, less experience was independently associated with incomplete excision using the less strict definition, whereas less experience and location on the head and neck area or upper extremities were independently associated with incomplete excision using the strict definition. Surgeon specialty was not associated with incomplete excision regardless of the definition. Conclusions: When removing BD surgically, an elliptical excision with surgical margins ≥3 mm carried out by an experienced surgeon should be recommended. Surgical margins may need to be adjusted depending on body site. Julia FougelbergHampus EkMagdalena ClaesonJohn PaoliMattioli1885articleBowen diseasedermatological surgerysurgical marginsnonmelanoma skin cancerDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 11, Iss 2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Bowen disease dermatological surgery surgical margins nonmelanoma skin cancer Dermatology RL1-803
spellingShingle	Bowen disease dermatological surgery surgical margins nonmelanoma skin cancer Dermatology RL1-803 Julia Fougelberg Hampus Ek Magdalena Claeson John Paoli Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
description	Background: One common treatment for Bowen’s disease (BD) is surgical excision, but there is no international consensus on the appropriate surgical margins. Objectives: This study examined what factors affect the rate of incomplete excision of BD. Methods: Clinicopathological data potentially linked to surgical outcome (complete or incomplete excision) were retrospectively collected from medical and histopathological records on all surgically excised BD lesions diagnosed at Sahlgrenska University Hospital in Gothenburg, Sweden during 2014-2015. Data were analyzed with two definitions of incomplete excision: less strict (ie, BD present at the surgical margin) and strict (ie, dysplasia present at the surgical margin). Results: In total, 463 BD lesions among 408 patients were included. With the less strict definition, 3 factors were associated with significantly higher rates of incomplete excision: surgical margins <3 mm, a less experienced surgeon, and use of punch biopsy excision. The same factors plus a tumor location on the head and neck area or upper extremities were associated with significantly higher rates of incomplete excision using the strict definition. After adjustment for confounders, less experience was independently associated with incomplete excision using the less strict definition, whereas less experience and location on the head and neck area or upper extremities were independently associated with incomplete excision using the strict definition. Surgeon specialty was not associated with incomplete excision regardless of the definition. Conclusions: When removing BD surgically, an elliptical excision with surgical margins ≥3 mm carried out by an experienced surgeon should be recommended. Surgical margins may need to be adjusted depending on body site.
format	article
author	Julia Fougelberg Hampus Ek Magdalena Claeson John Paoli
author_facet	Julia Fougelberg Hampus Ek Magdalena Claeson John Paoli
author_sort	Julia Fougelberg
title	Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
title_short	Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
title_full	Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
title_fullStr	Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
title_full_unstemmed	Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision
title_sort	surgery for bowen disease: clinicopathological factors associated with incomplete excision
publisher	Mattioli1885
publishDate	2021
url	https://doaj.org/article/5e0d9e3046af4a368b4c69adc25720b3
work_keys_str_mv	AT juliafougelberg surgeryforbowendiseaseclinicopathologicalfactorsassociatedwithincompleteexcision AT hampusek surgeryforbowendiseaseclinicopathologicalfactorsassociatedwithincompleteexcision AT magdalenaclaeson surgeryforbowendiseaseclinicopathologicalfactorsassociatedwithincompleteexcision AT johnpaoli surgeryforbowendiseaseclinicopathologicalfactorsassociatedwithincompleteexcision
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Surgery for Bowen Disease: Clinicopathological Factors Associated With Incomplete Excision

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