Analysis of effectiveness of a surgical treatment algorithm for basal cell carcinoma

Abstract

BACKGROUNDSurgical excision is the treatment of choice for basal cell carcinoma and micrographic surgery considered the gold standard, however not yet used routinely worldwide available, as in Brazil. Considering this, a previously developed treatment guideline, which the majority of tumors were treated by conventional technique (not micrographic) was tested.OBJECTIVETo establish the recurrence rate of basal cell carcinomas treated according to this guideline.METHODBetween May 2001 and July 2012, 919 basal cell carcinoma lesions in 410 patients were treated according to the proposed guideline. Patients were followed-up and reviewed between September 2013 and February 2014 for clinical, dermatoscopic and histopathologic detection of possible recurrences.RESULTSAfter application of exclusion criteria, 520 lesions were studied, with 88.3% primary and 11.7% recurrent tumors. Histological pattern was indolent in 85.5%, 48.6% were located in high risk areas and 70% small tumors. Only 7.3% were treated by Mohs micrographic surgery. The recurrence rate, in an average follow-up period of 4.37 years, was 1.3% for primary and 1.63% for recurrent tumors. Study limitations: unicenter study, with all patients operated on by the same surgeon.CONCLUSIONThe treatment guideline utilized seems a helpful guide for surgical treatment of basal cell carcinoma, especially if micrographic surgery is not available.

Recurrence rate of basal cell carcinoma among different micrographic surgery techniques: systematic review with meta‐analysis

“…In the comparative studies included in this review, MS recurrence rates were lower than CS rates, corroborating literature data that show MS and CS recurrence rates ranging between 1–5% and 5–18% respectively 54–56 . A systematic review covering all treatments for BCC reported a recurrence rate of 2.4% for MS (95% CI, 2.0–2.5%) and 4.1% for CS (95% CI, 2.5–4.2%) 57 .…”

“…In the comparative studies included in this review, MS recurrence rates were lower than CS rates, corroborating literature data that show MS and CS recurrence rates ranging between 1-5% and 5-18% respectively. [54][55][56] A systematic review covering all treatments for BCC reported a recurrence rate of 2.4% for MS (95% CI, 2.0-2.5%) and 4.1% for CS (95% CI, 2.5-4.2%). 57 Similarly, studies with follow-up of 5 years described recurrence rates of 1.0% and 10.1% in primary tumours and 5.6% and 17.4% in recurrent tumours for CS and MS respectively.…”

Head and neck cutaneous basal cell carcinoma: what should the otorhinolaryngology head and neck surgeon care about?

“…Alternatively, MMS may be performed for complete tumour excision and tissue sparing, taking into account tumour size and location, as well as the aggressiveness of the cBCC 84 . A feasible and pragmatic algorithm for surgical management of primary and recurrent cBCC is presented in Figure 3 85,86 . Surgical excision is fast, inexpensive and well accepted, and usually has good long-term functional and aesthetic outcomes.…”

Adequacy of surgical margins, re-excision, and evaluation of factors associated with recurrence: a retrospective study of 769 basal cell carcinomas

“…In another study, Luz et al evaluated the recurrence rates after surgical treatment using the algorithm they had developed and found a recurrence rate of 1.3% for primary tumors and 1.63% for recurrent tumors during a mean follow-up period of 4.37 years. 27 The fact that our proposed algorithm was used to evaluate retrospective data made it difficult to comment on the recurrence rates. However, the fact that the recurrence rates in both our and Luz et al’s studies were found to be lower compared to those in the literature indicates the usability of our proposed algorithm.…”