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Video

Head and Neck Surgery

(A622) Risk of No Residual Disease from Head and Neck BCC Excisions following Shave Biopsy

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Bryan D. Le, MD

    Resident Physician
    Kaiser Permanente Med Group - Northern California
    Alameda, California, United States

    • Author(s)

  • Sacha Moufarrej, MA

    Medical Student
    University of California San Diego School of Medicine
    San Diego, California, United States

  • Lisa E. Chionis, MD

    Resident
    Kaiser Permanente Northern California
    Oakland, California, United States

  • Benjamin D. Malkin, MD

    Senior Physician
    Kaiser Permanente East Bay
    Oakland, California, United States

    • Senior Author(s)

  • KW

    Kevin H. Wang, MD

    Kaiser Permanente East Bay, United States

Disclosure(s):
Bryan D. Le, MD: No relevant relationships to disclose.
Sacha Moufarrej, MA: No relevant relationships to disclose.
Lisa E. Chionis, MD: No relevant relationships to disclose.
Benjamin D. Malkin, MD: No relevant relationships to disclose.


Introduction: To investigate the risk of and factors associated with no residual disease in basal cell carcinoma (BCC) wide local excisions (WLE) performed following an initial shave biopsy.

Methods: This is a retrospective cohort study of patients in an integrated health system referred from dermatology to otolaryngology—head and neck surgery. Medical records of adults with shave biopsy-confirmed BCC referred for WLE between January 2022 and December 2023 were reviewed. Data collection included patient demographics, biopsy results, pre-procedure photographs uploaded to the electronic medical record, and relevant medical history. Univariate analysis was performed using chi-square tests, and multivariate logistic regression was conducted to assess the association between patient factors and outcomes.

Results: Among 243 cases, 27.2% (N=66) had no residual disease. Patients with no residual disease were younger on average compared to those with residual cancer (65.44 ± 14.16 years vs. 72.62 ± 12.95 years, p< 0.001). Of the 97 female cases, 40.2% (N=39) had no residual disease. Multivariate analysis revealed significant associations with gender: females were more likely to have no residual disease (OR 3.308, 95% CI 1.800-6.476, p< 0.001). No significant differences were observed based on comorbidities such as diabetes mellitus (DM), prior radiation history, or transplant history. Histologic subtypes showed no significant associations with residual disease status (p>0.05 for all subtypes).

Conclusions: This study highlights that gender and age are significant predictors of residual disease status in BCC patients undergoing WLE, while histologic subtype and comorbidities do not show significant associations. These findings may help guide pre-operative decision-making and counseling, particularly in balancing the potential morbidity of unnecessary procedures in cosmetically sensitive areas or in patients with limited life expectancy. Future research should focus on integrating these predictors into risk stratification models to minimize overtreatment.