The Appropriateness of Curettage and Electrodesiccation for the Treatment of Basal Cell Carcinomas

Alexiades-Armenakas, Macrene

doi:10.1001/archderm.136.6.800

Cited by 13 publications

(8 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In skilled hands curettage can approach the effieaey of surgical exeision (1,15,22), with cure rate of 90% or higher. However, for the inexperienced physicians the recurrence rates of over 30% are not uncommon, due to a poor curettage technique or inappropriate selection of patients (15,17,23).,Supervision and more intensive teaching of dermatology residents results in a mucb lower recurrence rates (23) wbieh is supported here by the data showing a greater than 6-fold decrease in relapses wbere the BCC were treated in a setting of a specialized skin cancer unit in our institution. Ctirettage does not seem to be an appropriate modality lor the treatment of recurrent tumours and poses a bigh risk of relapse.…”

Section: Discussionmentioning

confidence: 56%

Factors Affecting the Recurrence Rate of Basal Cell Carcinoma

Bøgelund¹,

Philipsen²,

Gniadecki³

2007

Acta Derm Venereol

View full text Add to dashboard Cite

The aim of this retrospective survey was to determine recurrence rates after treatment of basal cell carcinomas in a single academic dermatology department. A total of 1016 patients with 1593 histologically verified basal cell carcinomas (n=1212 primary and n=381 relapsing) were included. Tumour localization, T-stage and the method of treatment were significant predictors of the risk of recurrence (forward Cox regression, p <0.001). The relapse rate for primary basal cell carcinomas on the scalp was highest (odds ratio (OR)=2.8, 95% confidence interval (CI) 1.5-5.3). T2 and T3 tumours showed a 2- and 3-fold increased relapse rate, respectively, compared with T1 basal cell carcinomas. Radiotherapy and surgical excision had the lowest relapse rates, whereas curettage and photodynamic therapy resulted in 5-year relapse rates of up to 70%. Patients with chronic skin diseases had a 50% lower risk of relapse than healthy patients (OR=0.5, CI=0.3-0.8). Recurrent basal cell carcinomas had a higher relapse rate than primary lesions (OR=1.8, CI=1.4-2.2). Patients treated in a specialized skin cancer unit had a 6.4-fold (CI=2.4-17.4) higher cure rate compared with those treated by less experienced physicians. Thus, in an uncontrolled, real-life situation curettage or photodynamic therapy are associated with significantly higher relapse risk than excision and radiotherapy and therefore should not be used for high risk primary tumours or recurrent tumours. Treatment in the setting of a specialized skin cancer unit yields a much lower relapse rate.

show abstract

Section: Discussionmentioning

confidence: 56%

Factors Affecting the Recurrence Rate of Basal Cell Carcinoma

Bøgelund¹,

Philipsen²,

Gniadecki³

2007

Acta Derm Venereol

View full text Add to dashboard Cite

show abstract

“…The former two treatments are often touted as efficacious and inexpensive; the calcu-lated cost of ED&C is $471 on the face and $392 on an extremity. [17][18][19][20][21] When the cost of initial visit, biopsy, and 5-year follow-up are included (a total of $571.98), the cost of ED&C increases dramatically. 12 These cost calculations include recurrences, which may range from 5.7% to as high as 13.2%, and treatment of such recurrences, which is likely to be with MMS.…”

Section: Discussionmentioning

confidence: 99%

Cost Analysis: Mohs Micrographic Surgery

Ravitskiy

Brodland

Zitelli

2012

Dermatologic Surgery

View full text Add to dashboard Cite

show abstract

“…[12][13][14] The types of BCC that should not be treated by CE include large tumors, infiltrating, fibrosing, and recurrent. [12][13][14] Several studies reported by New York University 2,7,9,15,16 showed that cure rates of primary BCC after CE are influenced by operator experience, histopathology, location, and size of the BCC. In 1991, Silverman et al 7 demonstrated that larger lesion, diameter, and high-risk anatomic sites were independent factors for high RR.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical excision has been recently indicated as the treatment of choice for most BCCs, and is considered superior to CE in terms of recurrence rate (RR), 1 although critics note that evidence for this statement is lacking. 1,2 In the long experience of one of the authors (T. R-V.), the clinical impression in an academic center is that recurrences after CE for BCC are low, even when located at medium-and high-risk facial sites, where it is generally recommended that CE be avoided. Because CE is a simple and low-cost procedure that can be performed in an ambulatory setting, we consider CE for BCC worthy of further statistical analysis.…”

mentioning

confidence: 99%