Surgical excision versus Mohs’ micrographic surgery for basal cell carcinoma of the face: A randomised clinical trial with 10year follow-up

Loo, Eva van; Mosterd, Klara; Krekels, Gertruud A. M.; Roozeboom, Marieke H.; Ostertag, J.U.; Dirksen, Carmen D.; Steijlen, P.M.; Neumann, H. A. Martino; Nelemans, Patty J.; Kelleners‐Smeets, Nicole W.J.

doi:10.1016/j.ejca.2014.08.018

Cited by 277 publications

(203 citation statements)

References 23 publications

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“…3 Multiple RCTs comparing standard surgical excision of BCC with topical medical therapy, C&E, photodynamic therapy (PDT), cryotherapy, radiation therapy, and MMS have been published. 32,[34][35][36][37][38][39] All the studies consistently reported low recurrence rates after standard excision of BCC with predominantly nonaggressive histologic growth patterns. Excision of nodular or superficial BCC with 3-to 4-mm margins in low-risk anatomic locations was associated with 2% to 4% recurrence rates after 3 to 5 years.…”

Section: Standard Excisionmentioning

confidence: 94%

“…The first RCT for MMS comparing MMS with standard excision of primary and recurrent facial BCC was conducted in the Netherlands. 32,33,49 In the final analysis, a 10-year recurrence rate of 4.4% was reported for primary facial BCC treated with MMS, compared with 12.2% (P = .100) following standard excision. For recurrent BCC, the 10-year recurrence rates were 3.9% and 13.5% (P = .023) after MMS and standard excision, respectively.…”

Section: Standard Excisionmentioning

confidence: 94%

“…In the same cohort, the local recurrence rate increased to 12.2% at 10 years, with 56% of recurrences identified beyond 5 years of followup. 32,33 Despite advances in topical and systemic therapies, as well as a variety of energy devices, surgery remains the cornerstone of BCC treatment. Three surgical treatment modalities are reviewed in this section: standard excision, MMS, and C&E. Nonsurgical therapies, including radiotherapy and cryosurgery, are addressed separately.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Only MMS was superior to standard excision for the treatment of primary and recurrent facial BCC after 5-and 10-years of follow-up. 32 When cosmetic outcome following various treatment modalities were evaluated, the appearance after standard excision was consistently judged more favorable than that after C&E or cryotherapy. 31,41 Although 2 studies reported better cosmetic outcomes following PDT compared with standard excision, recurrence rates were significantly higher with PDT (9.3% and 14% after 1 and 5 years, respectively) than with standard excision (0% and 4% after 1 and 5 years, respectively).…”

Section: Standard Excisionmentioning

confidence: 99%

“…For recurrent BCC, the 10-year recurrence rates were 3.9% and 13.5% (P = .023) after MMS and standard excision, respectively. 32 Cox regression analysis identified an aggressive histologic growth pattern as a significant risk factor for recurrence. 49 These findings cannot necessarily be extrapolated beyond the scope of the study population with facial BCC.…”

Section: Standard Excisionmentioning

confidence: 99%

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Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

311

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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Section: Standard Excisionmentioning

confidence: 94%

Section: Standard Excisionmentioning

confidence: 94%

Section: Surgical Treatmentmentioning

confidence: 99%

Section: Standard Excisionmentioning

confidence: 99%

Section: Standard Excisionmentioning

confidence: 99%

See 3 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

311

219

View full text Add to dashboard Cite

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Follow-up of Patients With Keratinocyte Carcinoma

et al. 2023

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ImportancePatients treated for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), collectively called keratinocyte carcinoma (KC), are at risk for recurrence, metastasis, and additional primary cutaneous malignant neoplasms. It is unclear how often patients should be seen for follow-up skin examination after initial treatment of KC.ObjectiveTo summarize the recommendations and evaluate the methodological quality of clinical practice guidelines for dermatologic follow-up of patients with BCC and invasive SCC.Evidence ReviewPubMed, MEDLINE, and Embase were searched for relevant articles published from January 2010 to March 2022. Search terms included guideline, squamous cell carcinoma, and basal cell carcinoma. National or international guidelines containing recommendations for follow-up frequency after a diagnosis of localized cutaneous KC were included. Quality was assessed using the 6 domains of the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool: (1) scope and purpose; (2) stakeholder development; (3) rigor of development; (4) clarity of presentation; (5) applicability; and (6) editorial independence. The Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) was used to guide study reporting.FindingsAmong the 14 guidelines meeting eligibility criteria, there was little consensus on the appropriate follow-up frequency after initial KC treatment. Overall duration of follow-up ranged from a single posttreatment visit to lifelong surveillance. Most guidelines stratified their recommendations by recurrence risk. For low-risk BCC and guidelines that did not stratify by risk, follow-up recommendations ranged from every 6 to 12 months. For high-risk BCC, 1 guideline suggested follow-up every 3 months, while 4 recommended every 6 months. For low-risk SCC, 5 guidelines recommended annual follow-up; 3 guidelines, every 6 months; and 1 guideline, every 3 months. For high-risk SCC, recommendations included a range of follow-up frequencies, spanning every 3 months (n = 5 guidelines), 4 months (n = 1), 6 months (n = 6), or annually (n = 4). One guideline did not use risk stratification and recommended annual screening. The highest scoring AGREE II domain was “scope and purpose,” which assessed the guideline’s overall objectives, and the lowest scoring was “applicability,” which assessed barriers and facilitators to implementation.Conclusions and RelevanceThe findings of this systemic review highlight variations in follow-up recommendations for patients after initial treatment for KC. Randomized clinical trials are needed to define an optimal follow-up regimen.

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Rapid Intraoperative Molecular Characterization of Glioma

et al. 2015

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IMPORTANCE Conclusive intraoperative pathologic confirmation of diffuse infiltrative glioma guides the decision to pursue definitive neurosurgical resection. Establishing the intraoperative diagnosis by histologic analysis can be difficult in low-cellularity infiltrative gliomas. Therefore, we developed a rapid and sensitive genotyping assay to detect somatic single-nucleotide variants in the telomerase reverse transcriptase (TERT) promoter and isocitrate dehydrogenase 1 (IDH1). OBSERVATIONS This assay was applied to tissue samples from 190 patients with diffuse gliomas, including archived fixed and frozen specimens and tissue obtained intraoperatively. Results demonstrated 96% sensitivity (95% CI, 90%–99%) and 100% specificity (95% CI, 95%–100%) for World Health Organization grades II and III gliomas. In a series of live cases, glioma-defining mutations could be identified within 60 minutes, which could facilitate the diagnosis in an intraoperative timeframe. CONCLUSIONS AND RELEVANCE The genotyping method described herein can establish the diagnosis of low-cellularity tumors like glioma and could be adapted to the point-of-care diagnosis of other lesions that are similarly defined by highly recurrent somatic mutations.

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Surgical excision versus Mohs’ micrographic surgery for basal cell carcinoma of the face: A randomised clinical trial with 10year follow-up

Cited by 277 publications

References 23 publications

Guidelines of care for the management of basal cell carcinoma

Guidelines of care for the management of basal cell carcinoma

Follow-up of Patients With Keratinocyte Carcinoma

Rapid Intraoperative Molecular Characterization of Glioma

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