E-Mail karger@karger.com Original Paper Dermatology 2016;232:550–557 DOI: 10.1159/000447354 Surgical Treatment of Facial Basal Cell Carcinoma: Patient-Based Assessment of Clinical Outcome in a Prospective Cohort Study Joséphine Ofaiche   a Raphael Lopez   b Emilie Bérard   e Aymeric André   c Cristina Bulai-Livideanu   a Thomas Méresse   c Benjamin B. Vairel   d Jean-Louis Grolleau   c Carle Paul   a Nicolas Meyer   a, f a  Department of Dermatology, Paul Sabatier University and Toulouse University Cancer Institute, Departments of b  Maxillofacial Surgery, c  Plastic and Reconstructive Surgery, and d  Otorhinolaryngology, Toulouse University Hospital (CHU), e  Department of Epidemiology, Health Economics and Public Health, Toulouse University Hospital (CHU), UMR1027 INSERM – University of Toulouse III, and f  INSERM UMR 1037 – CRCT, Toulouse, France dently associated with poorer POSAS. In terms of the inves- tigator’s evaluation, aging signs (protective factor: OR = 0.17, 95% CI: 0.04–0.73; p = 0.01), location on the H-zone of the face (risk factor: OR = 2.95, 95% CI: 1.07–8.15; p = 0.03), and histologically infiltrative or sclerosing BCC (risk factor: OR = 2.89, 95% CI: 1.01–8.29; p = 0.04) were independently associ- ated with POSAS. Conclusion: Esthetic, functional, and mor- phological outcomes of facial BCC surgery provide high pa- tient satisfaction overall. Taking wider margins requires spe- cific measures to improve the surgical outcome. © 2016 S. Karger AG, Basel Introduction Basal cell carcinoma (BCC) is a locally invasive malig- nant skin tumor. Metastases are extremely rare [1], and morbidity results from local destruction. BCC is the most common cancer in the Caucasian population [2]. The most widely documented etiological factor appears to be exposure to ultraviolet radiation [3]. Sun-exposed areas of the head and neck are the most common anatomic lo- cations involved in BCC [4, 5]. Key Words Basal cell carcinoma · Dermatological surgical procedures · Esthetic unit · Face · Patient and Observer Scar Assessment Scale · Treatment Abstract Background: There are limited data on the esthetic, func- tional, and morphological outcomes of surgical treatment of facial basal cell carcinoma (BCC). Objective: The aim of our study was to assess the determinants of the evaluation of both the patients and the investigator of the esthetic, func- tional, and morphological impact of the surgical treatment of facial BCC. Methods: A prospective observational study evaluated 111 patients treated surgically for facial BCCs (n = 135 BCCs), using the Patient and Observer Scar Assessment Scale (POSAS), a validated and reliable scale designed for the evaluation of all types of scars by professionals and patients. Results: Scar assessment rated by the patients was very good. Skin aging was associated with a better surgical out- come as evaluated by POSAS (OR = 0.30, 95% CI: 0.09–0.98; p = 0.04). Conversely, histologically infiltrative or sclerosing BCC (OR = 2.33, 95% CI: 0.95–5.71; p = 0.06) was indepen- Received: November 18, 2015 Accepted after revision: May 27, 2016 Published online: September 28, 2016 Prof. Nicolas Meyer Service de Dermatologie, Hopital Larrey 24 Chemin de Pouvourville, TSA30030 FR–31059 Toulouse Cedex 9 (France) E-Mail meyer.n  @  chu-toulouse.fr © 2016 S. Karger AG, Basel 1018–8665/16/2325–0550$39.50/0 www.karger.com/drm Downloaded by: 54.70.40.11 - 11/20/2017 12:38:35 PM