Remission may be more likely in metastatic basal cell carcinoma limited to lymph nodes

Key takeaways:

• A study focused on metastatic basal cell carcinoma outcomes based on metastasis location.
• Eleven patients with nodal metastasis achieved complete remission compared with one patient with distant metastasis.

Patients with metastatic basal cell carcinoma experiencing distant organ involvement have worse outcomes than patients with nodal involvement, according to a study.

“Basal cell carcinoma (BCC) is the most common malignancy, with an estimated incidence of 2 million cases in the United States annually,” Morgan Groover, of the department of dermatology, Brigham and Women’s Hospital, Harvard Medical School, and colleagues wrote. “Metastatic BCC (mBCC) is rare, with estimated rates ranging between 0.0028% to 0.03%.”

The authors conducted a retrospective cohort study of 53 patients with mBCC to assess outcomes based on metastasis location. Data were retrieved from four large academic centers from Jan. 1, 2005, to Dec. 31, 2021.

Of the 53 patients, 22 (42%) had disease spread limited to lymph nodes while 31 (58%) experienced distant organ spread, with 16 of those experiencing lymph node involvement as well.

Eleven patients (50%) with nodal metastasis achieved complete disease remission compared with one patient (3%) with distant metastasis.

Fourteen patients (45.2%) with distant metastasis died compared with two patients (9.1%) with nodal metastasis (P = .01). Patients with distant metastasis experienced worse 5-year disease-specific survival (61%) compared with those with nodal metastasis (89.3%), but the difference was not statistically significant.

Neither cohort had a clear first-line treatment regimen, limiting any meaningful conclusions about the ideal treatment. In addition, the study was limited by the small sample size, even though it was one of the largest real-world cohorts of mBCC.