Overall treatment success after treatment of primary superficial basal cell carcinoma: a systematic review and meta-analysis of randomized and nonrandomized trials

Roozeboom, Marieke H.; Arits, A.H.H.M.; Nelemans, Patty J.; Kelleners‐Smeets, Nicole W.J.

doi:10.1111/j.1365-2133.2012.11061.x

Cited by 136 publications

(118 citation statements)

References 58 publications

(376 reference statements)

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“…Their Kaplan-Meir plot suggested a steeper slope for recurrences over years 1 to 3. Another systematic review of interventions for superficial BCC in 2012 found pooled estimates from 23 randomized and non-randomized studies of 87·3% for imiquimod (95% CI 84-91%) and 84·0% for PDT (95% CI 78-90%) (Roozeboom et al, 2012). A subsequently published non-inferiority RCT performed a head to head comparison between topical 5-FU, topical 5% imiquimod and methyl aminolevulinate-photodynamic therapy (MAL-PDT) in 601 patients with superficial BCC, followed up for 1 and 3 years (Arits et al, 2013;Roozeboom et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

Williams

Bath‐Hextall

Ozolins

et al. 2017

Journal of Investigative Dermatology

116

106

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Abbreviations BCC = basal cell carcinoma; nBCC = nodular basal cell carcinoma sBCC = superficial basal cell carcinoma; PDT = photodynamic therapy RCT = randomised controlled trial Abstract -200 words Main text -2600 words Tables -1 Figures -1 References -23 2 ABSTRACT Background: We previously reported modest clinical 3-year benefit for topical imiquimod compared with surgery for superficial or nodular basal cell carcinoma (sBCC, nBCC) at low risk sites in our non-inferiority randomised controlled SINS trial. Here we report 5-year data.Methods: Participants were randomised to imiquimod 5% cream once daily (sBCC, 6 weeks; nBCC, 12 weeks) or excisional surgery (4 mm margin). Primary outcome was clinical absence of initial failure or signs of recurrence at 3 year dermatology review. Five year success was defined as 3 year success plus absence of recurrences identified through hospital, histopathology and general practitioner records. Results:Of 501 participants randomised, 401 contributed to the modified intention-to-treat analyses at year 3 (primary outcome), 383 (96%) of whom had data at year 5. Five year success rates for imiquimod were 82·5% (170/206) compared to 97·7% (173/177) for surgery (relative risk of imiquimod success 0·84, 95% CI 0·77 to 0·91, p<0.001). These were comparable to year 3 success rates of 83·6% (178/213) and 98.4% (185/188), for imiquimod and surgery, respectively. Most imiquimod treatment failures occurred in year one. Interpretation:Although surgery is clearly superior to imiquimod, this study shows sustained benefit for lesions that respond early to topical imiquimod.

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Section: Discussionmentioning

confidence: 99%

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

Williams

Bath‐Hextall

Ozolins

et al. 2017

Journal of Investigative Dermatology

116

106

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“…[96][97][98] Monotherapy with topical 5-FU, an antimetabolite, for superficial BCC is less well studied in welldesigned RCTs. 74,75 Typical regimens include twice-daily application for 3 to 6 weeks. Adverse events are similar to those with imiquimod and include erythema, swelling, crust, erosions, ulcers, and eschar.…”

Section: Topical Therapiesmentioning

confidence: 99%

“…35,38,64,74,76,77,[80][81][82]86,87,99 Application of the photosensitizer is often preceded by light curettage of BCCs. 99 Usually a single treatment cycle is performed, but treatments may be repeated.…”

Section: Photodynamic Therapymentioning

confidence: 99%

“…Earlier pooled data from 28 studies of variable quality indicated the 12-week post-treatment complete response rates of superficial BCC to be 86% for imiquimod and 79% for PDT, with inadequate data for 5-FU because of a dearth of studies. 74 So-called ''field treatment'' is designed to treat small incipient BCCs within an anatomic area or region. Topical treatments have been reported to be effective for combatting field cancerization.…”

Section: Comparative Effectiveness Of Topical Therapiesmentioning

confidence: 99%

“…Longterm data regarding the safety and effectiveness of pulsed dye or Er:YAG lasers for treatment of BCC are lacking. 74,93,104 …”

Section: Laser Therapymentioning

confidence: 99%

See 2 more Smart Citations

Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

315

219

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Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed. ( J Am Acad Dermatol

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Reevaluating Mohs Surgery Appropriate Use Criteria for Primary Superficial Basal Cell Carcinoma

Steinman¹,

Dixon

Zachary

2018

JAMA Dermatol

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Overall treatment success after treatment of primary superficial basal cell carcinoma: a systematic review and meta-analysis of randomized and nonrandomized trials

Cited by 136 publications

References 58 publications

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial

Guidelines of care for the management of basal cell carcinoma

Reevaluating Mohs Surgery Appropriate Use Criteria for Primary Superficial Basal Cell Carcinoma

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