Factors Affecting the Recurrence Rate of Basal Cell Carcinoma

Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark.
Acta Dermato Venereologica (Impact Factor: 3.03). 01/2007; 87(4):330-4. DOI: 10.2340/00015555-0236
Source: PubMed


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.

Download full-text


Available from: Robert Gniadecki
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to analyze the scope of pre-surgical high resolution ultrasound in basal cell carcinoma (BCC). BCC is the most common human cancer. According to recent large prospective studies incomplete excision of BCC is higher than expected. Pre-operative imaging may aid surgical planning by identifying the extent and location of a neoplasm, which can be interesting at zones with higher risk of recurrences such as the face. These are slow growing tumors but there are some aggressive types described that can involve deeper structures. Twenty-five patients were studied (10 F/15 M, 48-91 years old; mean age 69.5+/-11.5 years) with suspicious facial lesions < or =1.5 cm. Pre-surgical ultrasound with compact linear 15-7 MHz probe was performed. Ultrasound reported the morphology and thickness of the tumors. The results were correlated with the histology. Ultrasound identified 29 suspicious facial lesions that were removed with tumor-free borders at the first surgery and confirmed by histology. The main location was the nose. Two subclinical satellite lesions at the nasal zone were detected under ultrasound which led to a change in the surgery plan. The intraclass correlation coefficient (ICC) value was used to compare tumor thickness measurements between ultrasound and histology. ICC was considered as very good (0.9). Therefore, ultrasound can be useful to plan BCC surgery, it can recognize lesions, layers of involvement and vascularity patterns in a non-invasive way. It can show subclinical satellite lesions, even though the number of subclinical cases is small and require further investigations. It has a good thickness correlation with histology and may be used as a technique to monitor disease changes following non-invasive medical treatments in the future.
    Full-text · Article · Sep 2008 · Cancer Imaging

  • No preview · Article · Jan 2009 · Journal der Deutschen Dermatologischen Gesellschaft
  • [Show abstract] [Hide abstract]
    ABSTRACT: This retrospective study was carried out to assess the clinical outcome of stage I (ie, T1 N0 M0) head and neck basal cell carcinoma (HNBCC) and verify the impact of some clinical parameters on prognosis. The cases of 220 patients with stage I (ie, T1 N0 M0) histologically proven HNBCC were analyzed.The global disease-specific survival rate at 36 months was 100%, irrespective of the type of surgery, and thus, it was demonstrated that radical tumor resection is a viable procedure for stage I HNBCC. However, 11 (5%) of 220 cases had a recurrence. A second procedure was performed in 10 (90.9%) of 11 cases. In 3 of the 10 patients operated on twice (30%), a second recurrence was detected. Thus, a second surgical procedure on a recurring tumor is possible, but the multimodality treatment regimen should be considered for recurring tumors.
    No preview · Article · Feb 2009 · The Journal of craniofacial surgery
Show more