Abstract
Background
Postoperative management of close or positive margins after conventional excision of facial nonmelanoma skin cancer is challenging, especially in elderly patients and anatomically constrained sites where re‐excision may impose functional or aesthetic morbidity.
Methods
We retrospectively analysed 238 facial carcinoma cases treated by conventional excision at a peripheral ENT unit, including 172 basal cell carcinomas (BCC) and 66 squamous cell carcinomas (SCC). Margins were classified as clear, close or positive. Outcomes were analysed descriptively; two‐sided Fisher exact tests were used as exploratory descriptors of distributional imbalance under sparse‐event conditions, not as tests of treatment superiority or equivalence.
Results
In BCC, no recurrence occurred after clear margins (0/90). Among non‐clear‐margin BCCs, recurrence remained uncommon after structured surveillance (5/65) and early re‐excision (1/17). In SCC, recurrence occurred only after positive margins (3/15), with none after clear or close margins.
Conclusion
The findings support histotype‐specific postoperative interpretation of margin status after conventional facial skin cancer excision. In this cohort, selected lower‐risk BCC cases were managed through structured surveillance, whereas SCC recurrence was confined to positive‐margin cases, supporting a lower threshold for timely re‐excision or equivalent oncologic management when clinically feasible.