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Treatment of Recurrent Nonmetastatic Basal Cell Carcinoma of the Skin
Source: Skin Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 12, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Context: Treatment of Basal Cell Carcinoma of the Skin
After treatment of BCC, patients are monitored clinically and examined regularly. Most recurrences occur within 5 years, but about 18% of recurrences are diagnosed beyond that point.[11]
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Patients who develop a primary BCCs are also at increased risk of subsequent primary skin cancers because their sun-damaged skin is susceptible to additional cancers.[53-55] This effect is sometimes termed field carcinogenesis. Age at diagnosis of the first BCC (<65 years), red hair, and initial BCC on the upper extremities appear to be associated with a higher risk of subsequent new BCCs.[56]
Treatment options for recurrent nonmetastatic BCC of the skin include:
Surgical excision.
Mohs micrographic surgery.
Mohs micrographic surgery is commonly used for local recurrences of BCC.
Evidence (surgical excision vs. Mohs micrographic surgery):
In a separate group within a randomized trial that compared excision with Mohs micrographic surgery for primary BCCs, 204 patients with recurrent BCCs were randomly assigned to undergo either excision or Mohs micrographic surgery.[12][Level of evidence B1]
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In a separate group within a randomized trial that compared excision with Mohs micrographic surgery for primary BCCs, 204 patients with recurrent BCCs were randomly assigned to undergo either excision or Mohs micrographic surgery.[12][Level of evidence B1]
The recurrence rates were 8 of 102 patients assigned to excision and 2 of 102 patients assigned to Mohs micrographic surgery, after a mean follow-up of 2.08 years (P = NS).[12][Level of evidence B1]
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In a separate group within a randomized trial that compared excision with Mohs micrographic surgery for primary BCCs, 204 patients with recurrent BCCs were randomly assigned to undergo either excision or Mohs micrographic surgery.[12][Level of evidence B1]
There were more postoperative complications—including wound infections, graft necrosis, or bleeding—in the excision group than in the Mohs surgery group (19% vs. 8%, P = .021).
In a separate group within a randomized trial that compared excision with Mohs micrographic surgery for primary BCCs, 204 patients with recurrent BCCs were randomly assigned to undergo either excision or Mohs micrographic surgery.[12][Level of evidence B1]
As with primary tumors, the operative costs associated with Mohs surgery were higher than those associated with excision (489.06 Euros vs. 323.49 Euros; P = .001).
Publication references
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Preserved source evidence · Not medical advice