Cryosurgery in difficult to treat basal cell carcinoma.

Abstract

Basal cell carcinoma (BCC) is the most common human malignancy. Although BCC has a low mortality, it has a large morbidity. Patients frequently present with difficult to treat BCC because of the lesion itself, the condition of the patient, or both. Satisfactory results have been reported in the cryosurgery of low-risk BCC. There is no agreement, however, about indication, cure rate, technical modalities, and results of cryosurgery in tumors larger than 1 cm, in critical locations, and of aggressive histologic type. The purpose of the study was to establish the cure rate, functional preservation, cosmetic results, acceptance, and complications of cryosurgery in difficult to treat BCC. One hundred and thirty six consecutive patients with 171 difficult to treat BCC (because of size, location, nature, or patient condition) were treated by the mixed technique of curettage followed by liquid nitrogen application. After an average follow-up of 5.2 years (6 months to 9.1 years), a cure rate of 91.8% was achieved. The treatment was well tolerated, widely accepted by the patients, of low cost, and with good functional and cosmetic results. Complications were few and minor. Cryosurgery is a well-tolerated therapeutic modality that offers an acceptable cure rate and good functional and cosmetic results in difficult to treat BCC.