A Comparative Study of Clinical Features and Treatments of Basal Cell Carcinoma in Japan and the United States

Abstract

Quality of life is an important outcome in the treatment choice for basal cell carcinoma (BCC), which is rarely fatal. In this study, a comparison was made between patients with BCC undergoing a procedure with total excision in Hokkaido University (Japan) and those undergoing Mohs surgery in Miami University (United States). We have analyzed the age, gender distribution, site of the lesion, histopathological subtype, and clinical appearance. Outcome measures including surgical margin, type of anesthesia, operative time, and type of reconstruction, were also analyzed. There were striking differences in the clinical characteristics of BCC, with a significantly higher rate of the pigmented subtype in Japan. Patients who underwent Mohs surgery had significantly smaller surgical margins but a much higher rate of the total operative time. As a result, significantly more general anesthesia and skin grafting were performed in the total excision group as compared with Mohs surgery group. We conclude that quality of life outcome is one of the most important factors for the selection of therapeutic measures. Therefore, Mohs micrographic surgery is a valuable option among the various therapies available in Japan.