Background: Non-melanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are among the most common malignancies worldwide. Complete surgical excision is crucial for minimizing recurrence and improving outcomes. However, challenges remain, particularly when margins are unclear, which leads to higher clinical and economic burdens. Methods: This retrospective cross-sectional study analyzed factors associated with incomplete excision rates (IERs) in 448 NMSC lesions excised from 413 patients between 2017 and 2022. Patient demographics, lesion characteristics, anatomical site, practitioner specialty, and histopathological data were assessed. Statistical analyses, including chi-square and t -tests, were performed using SPSS version 22, with P < 0.05 considered significant. Results: The overall IER was 29.0%. Younger patients (mean age: 64.2 years) had a significantly higher IER than older patients ( P = 0.026). In BCC cases, smaller lesions (≤10 mm) had a significantly higher IER (31.5%, P = 0.043), and excisions performed by dermatologists had the highest IER (31.9%, P = 0.045). General surgery had the lowest IER (8.3%). Gender was not significantly associated with IER ( P = 0.968). Most lesions (92.4%) were located on the head and neck, though the anatomical site did not significantly affect IER. Conclusion: Incomplete excision remains a significant challenge in the surgical management of NMSC, particularly in younger patients, small BCC lesions, and cases treated by dermatologists. These findings highlight the need for a more meticulous surgical approach, particularly in high-risk cases. Optimizing surgical margins, refining excision techniques, and improving training protocols may help reduce IER and enhance patient outcomes.
Pakbaz et al. (Mon,) studied this question.