Factors Predictive of Recurrence of Basal Cell Carcinoma

Dixon, Anita; Lee, Saing H.; McGregor, Douglas H.

doi:10.1097/00000372-198906000-00005

Cited by 109 publications

(94 citation statements)

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“…Whether age predicts for recurrence is controversial; most published work suggests that it plays no role 7,12 . Radiotherapy modality and treatment energy are chosen depending on tumour and patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Recurrence after Radiotherapy for Non-Melanoma Skin Cancer

et al. 2014

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present study was to determine predictive factors for recurrence in patients treated with radiotherapy for nmsc. METHODSAt the Odette Cancer Centre multidisciplinary clinic, patients are jointly assessed by a dermatologist, a plastic surgeon, and a radiation oncologist. Patients receiving radiotherapy for bcc or scc between January 2007 and December 2011 were included in the study. Approval was obtained from the Sunnybrook Health Sciences Centre Research Ethics Board.The clinic's prospective database records patient and tumour factors at initial consultation and treatment outcomes at follow-up. Patient factors recorded include age; tumour size; site; pathology; and whether the disease is primary, recurrent, or treated postoperatively. Any immunosuppressantrelated predisposing conditions-including but not limited to chronic lymphocytic leukemia, solid organ transplantation, hiv infection, and lymphoma-are recorded. Treatment factors recorded include dose and fractionation, biologic equivalent dose in 2-Gy fractions (eqd 2 ), and treatment modality.Radiotherapy was delivered using orthovoltage X-rays, electrons, or megavoltage photons. Orthovoltage energies used were 100 kV, 180 kV, 250 kV, and 300 kV (dose prescribed at skin surface, with a focus-to-skin distance of 30 cm or 50 cm). Electron energies used included 6 MeV, 9 MeV, 12 MeV, 14 MeV, 15 MeV, and 18 MeV, with dose prescribed to 95%. Bolus was used to ensure a full skin dose. Photons were delivered in a 1-or 2-field technique, with intensity-modulated radiotherapy used in selected cases. The choice of treatment modality and energy depended on the tumour size, depth, and location. For tumours thicker than 1 cm or larger than 3 cm, electrons or photons were used. Clinical mark-up was used to define the gross tumour volume in most cases, with computed tomography planning reserved for deep-seated tumours. The treatment volume included ABSTRACTPredictive factors of recurrence were examined in 448 non-melanoma skin cancers (72% basal cell carcinoma, 28% squamous cell carcinoma) treated with radiotherapy. The overall recurrence rate was 15.8% at a median follow-up of 18.4 months. In multivariate analysis, significant factors for recurrence were age (p = 0.0197), tumour size 2 cm or greater (p = 0.0095), immunosuppression (p = 0.0082), and treatment modality (p = 0.0009).

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Section: Discussionmentioning

confidence: 99%

Predictors of Recurrence after Radiotherapy for Non-Melanoma Skin Cancer

et al. 2014

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“…BCC with mixed histology is most commonly found on the nose, followed by the ear, cheek, and scalp. This is not surprising as the most frequently reported site for either primary or recurrent BCCs is the nose (55,56). BCCs with mixed histology (almost 40%) should be treated according to their most aggressive histopathological subtype.…”

Section: Bcc With Mixed Histology Bcc With Mixed Histology (Bcc-mh)mentioning

confidence: 99%

An Overview on Basal Cell Carcinoma

Avcı¹

2011

Skin Cancer Overview

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“…Tumor age has been shown to affect subclinical extension only indirectly through an increase in tumor diameter 48 and was not independently predictive of recurrence. 49 However, inclusion of these data in our model may have yielded more information.…”

Section: Commentmentioning

confidence: 99%

Predictors of Extensive Subclinical Spread in Nonmelanoma Skin Cancer Treated With Mohs Micrographic Surgery

Batra¹

2002

Arch Dermatol

158

130

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Background: In nonmelanoma skin cancer, the clinically visible portion may represent a small fraction of microscopic tumor spread. Previous studies have examined individual risk factors for subclinical spread based on patient and tumor characteristics. However, these risk factors have not been prioritized or studied in combination.Objective: To identify the most predictive risk factors for extensive subclinical tumor spread.Design: Retrospective analysis of 1131 Mohs micrographic surgical cases. Variables analyzed included patient age, sex, and immune status and lesion size, location, histologic subtype, and recurrence. Logistic regression was applied to identify important combinations of tumor characteristics and to quantify relative odds of spread.Setting: Academic referral center.Patients: Consecutive sample of all referred patients treated by a single Mohs micrographic surgeon in a 3-year period.Main Outcome Measure: Number of Mohs micrographic surgical layers required to clear a tumor, with 3 or more layers defined as extensive subclinical spread.Results: The highest-risk tumors, with odds ratios greater than 6.0, were basosquamous and morpheaform basal cell carcinoma (BCC) on the nose, morpheaform BCC on the cheek, and those with a preoperative size greater than 25 mm. Other important risk factors were recurrent and nodular BCC on the nose; location on the eyelid, temple, or ear helix; neck tumors and recurrent BCC in men; and tumor size greater than 10 mm. Patients younger than 35 years were at lower risk. Increasing age and immunocompromise were not significant predictors. Conclusion:Identification of lesions likely to exhibit extensive subclinical spread can help guide management to ensure complete tumor eradication and thereby reduce the risk of recurrence and its associated morbidity and cost.

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Factors Predictive of Recurrence of Basal Cell Carcinoma

Cited by 109 publications

References 0 publications

Predictors of Recurrence after Radiotherapy for Non-Melanoma Skin Cancer

Predictors of Recurrence after Radiotherapy for Non-Melanoma Skin Cancer

An Overview on Basal Cell Carcinoma

Predictors of Extensive Subclinical Spread in Nonmelanoma Skin Cancer Treated With Mohs Micrographic Surgery

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