Prospective Clinical Trial Comparing Curettage and Cryosurgery to Curettage and Electrodesiccation in the Management of Minimally Invasive Basal and Squamous Cell Carcinomas

Abstract

Background Basal and squamous cell carcinomas represent the most common cancers in North America. Their management is an important issue. Objectives The evaluation of cure rates of minimally invasive cutaneous carcinomas with curettage-cryosurgery compared to curettage-electrodesiccation, as well as the assessment of the aesthetic appearance of scars. Methods This prospective trial randomized 117 patients 1:1 to treatments of curettage-cryosurgery or curettage-electrodesiccation. They were then followed at 6, 12, 18, and 24 months. Results At 12-month follow-up, only one (1/49) patient had a recurrence of cutaneous carcinoma in the curettage-cryosurgery group and none (0/43) in the curettage-electrodesiccation group. Farrington-Manning analysis with a 5% margin of error showed the non-inferiority of the first method ( P = .04). For the aesthetic appearance of scars after 12 months, better results with curettage-cryosurgery procedure has been observed, but this was not statistically significant ( P = .80 and P = .27 for evaluations of patients and clinicians respectively). Limitations This study was mainly limited by its small sample size. Conclusion We have demonstrated that curettage-cryosurgery compared to curettage-electrodesiccation for the treatment of minimally invasive carcinomas is noninferior (comparable) with regards to cure rates at 12-month follow-up. No significant difference has been demonstrated for the appearance of scars.

“Basal cell carcinoma of the hand: A systematic review and meta-analysis of incidence of recurrence”

“…The following reasons prompted the exclusion of 59 articles: improper methods (systematic review, review article, and letter to editor), n = 12, no outcome of interest ( n = 19), the full text could not be located ( n = 14), the specific location of BCC was not stated ( n = 12), included non-hand BCC patients ( n = 2). Thirty-five studies were case reports, 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 2 studies were case series, 53 , 54 1 study was a prospective cohort analysis, 55 and the remaining studies were retrospective cohort studies. Two studies were published in Australia, 27 , 40 6 studies were published in Asia, 22 , 23 , 27 , 32 , 47 , 49 17 studies were published in Europe, 8 , 19 , 25 , 34 , 35 , 38 .…”

“…2007 20 CR USA 01-Jan 1/0 70 White level II Fournier et al. 2020 55 P Canada 73/100 53/47 NA White Level V Galeano et al. 2002 45 CR Italy 01-Jan 1/0 81 NA Level I Grine et al.…”

“… 40 In-situ lesions were reported in 4 studies, 22 , 30 , 32 , 39 and invasive lesions in 8 articles. 20 , 23 , 24 , 29 , 38 , 40 , 41 , 51 Treatment modalities included Moh surgery in 10 studies, 6 , 19 , 20 , 21 , 24 , 30 , 33 , 36 , 43 curettage and cryosurgery in 1 study, 55 amputation in 4 studies, 35 , 40 , 45 , 48 and surgical excision in the remaining studies.…”

“…2007 20 Thumb Nail Eroded plaque Yes Nodular BCC Fournier et al. 2020 55 Hand NA NA Superficial Galeano et al. 2002 45 dorsal and medial surface of left-hand thumb just distal to MP joint small flat ulcerated lesion painful exophytic mass on the dorsal and medial surface of his left thumb just distal to the MP joint, which had infiltrated the first commissura Bowenoid BCC Grine et al.…”

The efficacy of the treatment of patients with basal cell skin cancer with the use of a superpulsed CO2-laser

“…Доступен ряд физических методов лечения базальноклеточного рака кожи, включая лучевую терапию [3], электродессикацию и кюретаж [4], криохирургию [5], фотодинамическую терапию [6] и лазерное лечение, в том числе, использование CO2-лазера [7].…”