Wide local excision

Overview

• Keratinocyte skin cancer, the comparison that matters. The Cochrane review of 52 randomised trials and 6,690 participants concluded that surgical interventions have the lowest recurrence rates, and that non-surgical treatments used for low-risk basal cell carcinoma are less effective than surgical ones although their recurrence rates are acceptable and their cosmetic outcomes are probably superior. The quantified version: imiquimod cream against excision at low-risk sites gave recurrence of 16.4 percent against 1.6 percent at three years and 17.5 percent against 2.3 percent at five years.
• Cancer Research UK describes what a small excision involves in practice: local anaesthetic, removal of the whole abnormal area with a healthy margin, stitches, a dressing, removal of non-dissolvable stitches after one or two weeks at the GP surgery, and the possibility of further surgery if the pathologist finds the margin is not wide enough. For larger cancers it may be a general anaesthetic and a graft or a flap.