Factors Affecting the Recurrence Rate of Basal Cell Carcinoma

Bøgelund, Fie Saabye; Philipsen, Peter Alshede; Gniadecki, Robert

doi:10.2340/00015555-0236

Cited by 60 publications

(63 citation statements)

References 26 publications

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“…The scalp is regarded as a relatively high risk localization for recurrences (36,37). A subgroup analysis in the present study confirmed that lesions in the hairy scalp showed relatively more recurrences compared with other body sites in all 3 treatment groups: a CR 45% vs. 88% in the fi-actionated group and 29% vs. 75% in the non-fractionated group.…”

Section: Ada Derm Venereol 92supporting

confidence: 87%

Light Fractionation Significantly Improves the Response of Superficial Basal Cell Carcinoma to Aminolaevulinic Acid Photodynamic Therapy: Five-year Follow-up of a Randomized, Prospective Trial

Vijlder¹,

Sterenborg²,

Neumann³

et al. 2012

Acta Derm Venerol

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Photodynamic therapy (PDT) using topical porphyrin-precursors is a promising treatment for superficial basal cell carcinoma (sBCC), but it needs further optimization. The aim of this study was to compare 5-year lesion (complete) response rates of sBCC treated with topical aminolaevulinic acid (ALA)-PDT using a single illumination vs. ALA-PDT using a 2-fold illumination scheme. A prospective, randomized study was performed, in which 91 patients with 299 lesions were treated with a 2-fold illumination scheme with 2 light fractions of 20 and 80 J/cm2 delivered 4 and 6 h after a single application of 20% ALA, and 106 patients with 274 lesions were treated with a single illumination of 75 J/cm2 4 h after a single application of 20% ALA. All lesions were treated at a fluence rate of 50 mW/cm2. An interim time to event analysis of complete response (CR) rates at 12 months showed encouraging results, and therefore lesions were followed for 5 years post-therapy. A third group of 50 patients with 172 lesions treated with 2-fold illumination were included after the initial period and analysed separately. The CR rate was significantly greater following the 2-fold illumination than the single illumination (p = 0.0002, log-rank test). Five years after therapy the CR rate after 2-fold illumination was 88%, whereas the CR rate after single illumination was 75%. The CR rate in the third group of lesions, treated with 2-fold illumination was 97% and 88% at 12 months and 5 years after therapy, respectively. Long-term follow-up indicates superior efficacy in sBCC of ALA-PDT with 2-fold illumination compared with ALA-PDT with single illumination.

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Section: Ada Derm Venereol 92supporting

confidence: 87%

Light Fractionation Significantly Improves the Response of Superficial Basal Cell Carcinoma to Aminolaevulinic Acid Photodynamic Therapy: Five-year Follow-up of a Randomized, Prospective Trial

Vijlder¹,

Sterenborg²,

Neumann³

et al. 2012

Acta Derm Venerol

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“…The latent period between surgery and onset of recurrence varies, on average, from two months to two years; however, it occurs more frequently in the first six months, but there are reports of more than five years. [153][154][155][156][157] Surgical excisions with positive margins recur in 15% to 67% of cases; however, they may occur after the report of histopathologically free margins (1.3 to 4.0%). This occurs more commonly in multifocal superficial and sclerodermiform tumors.…”

Section: Prognosismentioning

confidence: 99%

“…[162][163][164] The recurrent tumor has a worse prognosis because the relationship between the tumor and its stroma may be altered as a result of treatment primarily established, facilitating its dissemination. It may show exulcerations, 154 more evident cellular dysplasia, loosening of the tumor cell cords, stromal fibrosis and reduction of peritumoral inflammatory reaction, increasing the spread of cancer cells. 4.9 The incidence of metastasis of BCC is rare and ranges from 0.0028% to 0.55%; less than 400 cases have been reported in the literature.…”

Section: Prognosismentioning

confidence: 99%

Epidemiologia do carcinoma basocelular

Chinem

Miot

2011

An. Bras. Dermatol.

122

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Basal cell carcinoma is the most common malignant neoplasm in humans and its incidence has increased over the last decades. Its high frequency significantly burdens the health system, making the disease a public health issue. Despite the low mortality rates and the rare occurrence of metastases, the tumor may be locally invasive and relapse after treatment, causing significant morbidity. Exposure to ultraviolet radiation is the main environmental risk factor associated with its cause. However, other elements of risk are described, such as light skin phototypes, advanced age, family history of skin carcinoma, light eyes and blond hair, freckles in childhood and immunosuppression. Behavioral aspects such as occupational sun exposure, rural labor and sunburns at a young age also play a role. Between 30% and 75% of the sporadic cases are associated with patched hedgehog gene mutation, but other genetic changes are also described. The tumor is commonly found in concomitance with skin lesions related to chronic sun exposure, such as actinic keratoses, solar lentigines and facial telangiectasia. The prevention of basal cell carcinoma is based on the knowledge of risk factors, early diagnosis and treatment, as well as on the adoption of specific measures, particularly in susceptible populations. The authors present a review of the epidemiology of basal cell carcinoma. Keywords: Injections, intradermal; Review; Skin; Therapeutics Resumo: O carcinoma basocelular é a neoplasia maligna mais comum em humanos e sua incidência vem aumentando nas últimas décadas. Sua grande frequência gera significativo ônus ao sistema de saúde, configurando problema de saúde pública. Apesar das baixas taxas de mortalidade e de rara ocorrência de metástases, o tumor pode apresentar comportamento invasivo local e recidivas após o tratamento, provocando importante morbidade. Exposição à radiação ultravioleta representa o principal fator de risco ambiental associado a sua gênese. Entretanto, descrevem-se outros elementos de risco: fotótipos claros, idade avançada, história familiar de carcinomas de pele, olhos e cabelos claros, sardas na infância e imunossupressão, além de aspectos comportamentais, como exercício profissional exposto ao sol, atividade rural e queimaduras solares na juventude. Entre 30% e 75% dos casos esporádicos estão associados à mutação do gene patched hedgehog, mas outras alterações genéticas são ainda descritas. A neoplasia é comumente encontrada concomitantemente com lesões cutâneas relacionadas à exposição solar crônica, tais como: queratoses actínicas, lentigos solares e telangiectasias faciais. A prevenção do carcinoma basocelular se baseia no conhecimento de fatores de risco, no diagnóstico e tratamento precoces e na adoção de medidas específicas, principalmente, nas populações susceptíveis. Os autores apresentam uma revisão da epidemiologia do carcinoma basocelular.

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“…Clinical risk factors that were suggested in previous studies include male sex, topographic localization (central region of the face involving the inner canthus, nostrils, and peri-auricular area), tumor size (recurrence increases by approximately 7% for each millimeter of tumor diameter), sun-sensitive skin, and age over 60 years at first presentation. [2,3] Histological risk factors are usually associated with the aggressive-growth variants such as sclerosing, mixed (nodular and sclerosing), and rarely superficial (multifocal) type. [4,5] It was also observed that deep margin involvement, the presence of sclerodermiform or metatypic basaloid squamous cells as well as pleomorphous morphology and/or peritumoral inflammatory infiltrates were all related to an increase in the probability of recurrence.…”

Section: Introductionmentioning

confidence: 99%