| Demographics | Operations | Histology outcomes | Clinical outcomes | |
|---|---|---|---|---|
| Non-melanoma skin cancer |
Patients: 1549 Male: female (% male): 966: 583 (62·4%) Mean age (SD): 73·4 (12·6) |
Lesions excised: 1847 Anaesthetic: Local – 1417 (97·7%) General – 29 (2·0%) Regional – 5 (0·3%) Unknown – 98 Location: Head & neck – 1275 (65·8%) Leg – 199 (10·3%) Trunk – 200 (10·3%) Arm – 90 (4·6%) Hand – 63 (3·3%) Foot – 16 (0·8%) Genitalia, perineum – 4 (0·2%) Reconstruction: Direct closure – 1002 (54·8%) Skin graft – 538 (29·4%) Flap – 229 (12·5%) Other – 59 (3·3%) Unknown – 19 Sutures: Absorbable – 971 (69·8%) Non-absorbable – 188 (13·5%) Mixture – 232 (16·7%) Unknown – 158 |
Histological diagnosis: BCC – 800 (46·9%) SCC – 476 (27·9%) Benign – 147 (8·6%) AK – 86 (5·0%) Bowen's disease 39 (2·3%) Melanoma – 8 (0·5%) Other – 149 (8.7%) Awaited – 142 Median tumour diameter (IQR): All – 12·0 mm (7·0-19·8) BCC – 12·0 mm (7·0-19·0) SCC – 15·0 mm (10·0-23·5) High-risk* lesions: BCC – 329 (41·1%) SCC – 304 (63·9%) Margins: Clear – 1234 (94·0%) Involved – 79 (6·0%) Awaited – 534 |
Complications: Uncomplicated – 1166 (93·0%) Infection – 38 (3·0%) Bleeding – 16 (1·3%) Graft/flap failure for other reason – 16 (1·3%) Other – 18 (1·4%) Patient not followed up – 9 Awaited/unknown – 286 Ongoing care: No further treatment/clinical surveillance – 1359 (94·0%) Listed for re-excision – 59 (4·1%) Referral to radiotherapy – 24 (1·7%) Re-excision & radiotherapy – 3 (0·2%) Unknown – 160 Awaited – 242 |
| Melanoma |
Patients: 501 Male: female (% male): 272: 229 (54·2%) Mean age (SD): 60·4 (17·5) |
507 operations (85 operations with multiple procedures): Biopsy – 149 WLE – 344 SLNB – 71 Lymph node dissection – 28 Anaesthetic: Local – 390 (76·9%) General – 116 (22·9%) Regional – 1 (0·2%) Sutures: Absorbable – 456 (93·1%) Non-absorbable – 25 (5·1%) Mixture – 9 (1·8%) Unknown – 17 Reconstruction following WLE: Direct closure – 269 (78·7%) Skin graft – 42 (12·3%) Local flap – 24 (7·0%) Other – 7 (2·0%) Unknown – 2 |
Biopsy histological diagnosis: Melanoma – 41 (27·9%) Melanoma in-situ – 12 (8·2%) Dysplastic naevus – 7 (4·8%) Benign – 79 (53·7%) Other – 4 (2·7%) BCC – 4 (2·7%) Awaited – 2 WLE completely excised: Yes – 311 (95·4%) No – 15 (4·5%) Awaited – 18 SLNB outcome: Negative – 48 (67·6%) Positive – 23 (32·4%) Lymph node dissection: Residual disease present – 20 (76·9%) Absent – 6 (23·1%) Awaited – 2 |
Develop COVID-19 post op: No – 279 (99·3%) Yes – 2 (0·7%) Unknown – 220 Complications: Uncomplicated – 420 (92·1%) Seroma – 10 (2·2%) Infection – 9 (2·0%) Bleeding – 2 (0·4%) Other – 15 (3·3%) Patient not followed up – 2 Awaited/unknown – 43 |
Prospective patient data collected on non-melanoma surgical excisions during lockdown (March 16 th – June 14 th 2020) from 32 Plastic Surgery units. Retrospective patient data on melanoma surgery (March 23 r – June 14 th 2020) from 20 Plastic Surgery units. A further 228 patients did not meet inclusion criteria (e.g. pre-clinical diagnosis other than skin cancer, incomplete demographic/operative details) and were excluded prior to analysis. Abbreviations used are AK = actinic keratosis, BCC = basal cell carcinoma, SCC = squamous cell carcinoma, SD = standard deviation, SLNB = sentinel lymph node biopsy, WLE = wide local excision. *High-risk BCC and SCC were defined using national guidelines by the British Association of Dermatologists for SCC and the Royal College of Pathologists dataset for histopathological reporting of primary cutaneous BCC.