Clinical Application of Narrow Margins Combined with Photodynamic Therapy in Surgical Treatment of Skin Cancers

Margin management remains a critical challenge in skin cancers surgeries. Wide local excision (WLE) typically requires extensive reconstruction, impairing quality of life (QoL), while photodynamic therapy (PDT) alone provides limited remission. This study compares narrow-margin surgery combined with PDT (NMS-PDT) to WLE in treating skin cancers. A retrospective analysis of 24 patients (12 S-PDT, 12 WLE) with BCC, SCC, or EMPD, followed for at least 6 months. NMS-PDT showed comparable complete and partial clearance rates to WLE, with no significant recurrence difference (P > 0.05). Both groups exhibited significant improvement in postoperative itching and Dermatology Life Quality Index (DLQI) scores (P < 0.001). NMS-PDT demonstrated superior DLQI improvement (P = 0.011), higher satisfaction (P = 0.04), and lower costs (P = 0.01). NMS-PDT is a cost-effective, anatomy-preserving palliative option for skin cancers, significantly enhancing QoL.