Therapy for basal cell epitheliomas by curettage only. Further study

Abstract

Thorough curettage alone, a simple, effective, inexpensive therapy, has now been used to treat 644 basal cell epitheliomas in 437 patients. Three hundred twenty-eight treatment sites have been evaluated for more than five years. There have been 28 recurrences. Cosmetic results are superior to those obtained with x-ray therapy and electrocoagulation, and appear to be at least equal to those following cryosurgery and excision surgery.

Treatment of basal cell carcinoma with curettage alone

“…22 The lack of association with tumor location and size has been observed in analyses of other treatment techniques. 1,2,[11][12][13][14][15][16][17][18][22][23][24][25] However, our recurrence rate of 5.5% (1/18) on the nose is identical to that found by Spiller and Spiller 13 for C&E. In addition, Silverman et al 12 noted a recurrence rate of only 4.5% for BCC of less than 6 mm in high-risk sites after C&E and concluded that it was an effective treatment for small BCC in any anatomical site.…”

“…The primary risks of C&E are hypertrophic scarring or keloids 15 and hypopigmentation. 1,2,11,15,[33][34][35] Hypertrophic scarring after curettage alone developed in only one of our patients (0.3%), and we noted less significant hypopigmentation compared with that found in sites treated with C&E, evidenced by healing in patients treated with both methods (Fig 1). Other authors have reported similar findings and have recommended avoiding or minimizing electrodesiccation.…”

“…All tumors with at least 5-year follow-up were included. The 5-year cure rate was compared with published cure rates for BCC treated with C&E. 1,2,[11][12][13][14][15][16][17][18] This study was approved by our institutional review board.…”

“…1,2 In addition, it has the potential to interact with implanted cardiac devices and delay healing. [3][4][5][6][7] Viral particles and potential carcinogens also have been identified in the smoke plumes of electrocautery devices.…”

“…1,[12][13][14][15][16][17][18] The same is true of curettage alone. 2,11 We present a clinical and pathologic review of BCC treated with curettage alone and report on 5-year recurrence rates and the clinical and pathologic predictors of recurrence.…”