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Turkish Journal of Medical Sciences

Abstract

Background/aim: Skin cancer is the most common malignancy worldwide, particularly among elderly individuals. Many lesions are detected at an early stage because of their visibility and can be excised under local anesthesia, thereby avoiding the risks associated with general anesthesia or sedation. This study aimed to evaluate patient- and tumor-related characteristics in skin cancer surgery performed under local anesthesia, with particular emphasis on age-related outcomes.

Materials and methods: This retrospective study included 533 patients with 613 histopathologically confirmed skin cancers excised under local anesthesia between 2019 and 2024. Demographic, histopathological, and surgical variables were recorded, including age, sex, tumor location, measured tumor area, histologic subtype, surgical margin status, reconstruction technique, and comorbid conditions. Patients were stratified into three age groups (<60, 60–80, and >80 years) for subgroup analyses. Statistical analyses were performed using the Mann–Whitney U test, Kruskal–Wallis test, chi-square test, and Spearman correlation analysis (SPSS version 26.0; IBM Corp., Armonk, NY, USA), with statistical significance set at p < 0.05.

Results: The mean patient age was 68.5 years. Most lesions (86.1%) were located in the head and neck region. Basal cell carcinoma (65.4%) and squamous cell carcinoma (21.0%) were the predominant histopathological diagnoses. Primary closure (43.8%) and fullthickness skin grafting (25.0%) were the most frequently performed reconstruction methods. Larger tumor area was significantly associated with positive surgical margins (p < 0.01), and tumor type was significantly associated with both surgical margin status and reconstruction method (p < 0.0001). Age showed a statistically significant positive correlation with tumor area (p = 2.22 × 10-⁷) and with the presence of comorbidities (p < 0.001). Subgroup analysis demonstrated a higher proportion of squamous cell carcinoma and a larger mean tumor area in patients older than 80 years. No local anesthesia-related complications occurred.

Conclusion: Skin cancer surgery performed under local anesthesia appears to be safe and effective across age groups, including elderly and comorbid patients. Tumor type and tumor area were significantly associated with surgical margin status and reconstruction method. These findings support age-conscious and anesthesia-sparing approaches in oncologic dermatologic surgery.

Author ORCID Identifier

MENEKŞE KASTAMONİ BAŞKAN: 0000-0002-4667-1550

SÜLEYMAN ÇEÇEN: 0000-0003-2430-727X

SELÇUK AKIN: 0000-0003-1683-0722

ŞADUMAN BALABAN ADIM: 0000-0002-5039-164X

GÜZİN YEŞİM ÖZGENEL: 0000-0003-0000-8355

DOI

10.55730/1300-0144.6198

Keywords

Skin neoplasms, local anesthesia, surgical margins, reconstructive surgical procedures, aged

First Page

645

Last Page

653

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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