Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma

Background: surgical excision is the treatment of choice for basal cell carcinoma and micrographic surgery considered the gold standard,however not yet used routinely worldwide available,as in brazil. considering this,a previously developed treatment guideline,which the majority of tumors were treated by conventional technique (not micrographic) was tested . objective: to establish the recurrence rate of basal cell carcinomas treated according to this guideline. method: between may 2001 and july 2012,919 basal cell carcinoma lesions in 410 patients were treated according to the proposed guideline. patients were followed-up and reviewed between september 2013 and february 2014 for clinical,dermatoscopic and histopathologic detection of possible recurrences. results: after application of exclusion criteria,520 lesions were studied,with 88.3% primary and 11.7% recurrent tumors. histological pattern was indolent in 85.5%,48.6% were located in high risk areas and 70% small tumors. only 7.3% were treated by mohs micrographic surgery. the recurrence rate,in an average follow-up period of 4.37 years,was 1.3% for primary and 1.63% for recurrent tumors. study limitations: unicenter study,with all patients operated on by the same surgeon. conclusion: the treatment guideline utilized seems a helpful guide for surgical treatment of basal cell carcinoma,especially if micrographic surgery is not available. �2016 by anais brasileiros de dermatologia.