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ASDS consensus recommendations include Mohs micrographic surgery for high-risk BCCs
Mohs micrographic surgery is the treatment of choice for high-risk basal cell carcinomas and those located in cosmetically sensitive locations, according to a recently published consensus report.
Arielle N. B. Kauvar, MD, and colleagues conducted a comprehensive review of medical literature in an evaluation of optimal treatment methods for cutaneous basal cell carcinoma (BCC). Cure rates, recurrence rates, aesthetic and functional outcomes, and procedure cost-effectiveness were measured.
Arielle N.B. Kauvar
The group of dermatologic surgeons was appointed by the American Society for Dermatologic Surgery (ASDS) board of directors, according to a press release from the ASDS. The consensus document is intended to provide a set of clinical principles and courses of action for BCC management that physicians can follow, the release stated.
The researchers found at least a 10-fold increased incidence of second BCCs in patients with a history of BCC compared with patients without a history of nonmelanoma skin cancer.
According to the researchers, the best outcomes for BCCs were achieved through surgical approaches. The highest cure rates were achieved through Mohs micrographic surgery (MMS), which achieved maximum tissue preservation, maintenance of function and cosmesis.
Five-year recurrence rates following MMS was 1% for primary BCC and 5.6% for recurrent BCC, compared with 8.7% and 19.9%, respectively, for all non-MMS methods. Curettage alone or followed by electrodesiccation, radiation therapy, cryosurgery, photodynamic therapy and topical therapy were alternative BCC treatments discussed.
The researchers reported BCC incidences are increasing significantly, with more than 2.5 million new cases per year in the United States. Although optimal results for high-risk BCC are achieved through surgical approaches, including MMS, low-risk BCCs may be treated with surgical or nonsurgical modalities, the researchers concluded. – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.