Author(s): RodriguezVigil T, VzquezLpez F, PerezOliva N
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Abstract BACKGROUND: The incidence of basal cell carcinoma (BCC) is increasing. Curettage and electrodesiccation (CE) are not recommended for BCC treatment at medium- and high-risk facial sites. Surgical excision has been proposed as the treatment of choice. OBJECTIVE: We sought to evaluate the cumulative recurrence rate (RR) of primary BCC in facial areas of medium and high risk after CE. METHODS: This nonrandomized, clinical trial enrolled 257 patients with primary BCC located in medium- and high-risk facial areas, and treated with 4 or 5 cycles of CE by a single operator from a section specializing in BCC CE in a tertiary teaching hospital in Oviedo, Spain. Exclusion criteria for study entry included: recurrent BCC, fibrosing BCC, ill-defined BCC, and BCC larger than 10 mm in diameter (high-risk facial sites) or larger than 15 mm in diameter (medium-risk sites); BCC smaller than 4 mm; and nonbiopsy-proven BCC. BCCs included in the study were from the nose, and paranasal and nasal-labial fold (n = 105); eyelids and canthi (n = 48); perioral areas (n = 12); ears (n = 11); forehead and temples (n = 48); periauricular areas (n = 14); and malar areas and cheeks (n = 19). The primary outcome was recurrence of carcinoma, which was clinically evaluated by at least two observers in consensus. Data were analyzed using both a life table method and Kaplan-Meier analysis. The statistical analysis included best- and worst-case scenarios (which means that all cases lost to follow-up were considered as recurrences). RESULTS: The 5-year cumulative non-RR in the best-case scenario was 98.80\% (SE 0.70, 95\% confidence interval 97.40\%-100\%); thus, a 5-year cumulative RR of 1.20\% was found after CE in our medium- and high-risk BCCs of the face (best case). The 5-year cumulative non-RR in the worst-case scenario was 79.40\% (95\% confidence interval 78.90\%-79.90\%); thus, a 5-year cumulative RR of 20.60\%. LIMITATIONS: Retrospective design with a relatively small number of patients lost to follow-up is a study limitation. CONCLUSION: High 5-year cure rates can be obtained after CE of primary, nonfibrosing BCCs of medium- and high-risk areas of the face performed in a specialized section.
This article was published in J Am Acad Dermatol
and referenced in Atherosclerosis: Open Access