Primary Basal Cell Research Articles

Treatment of cutaneous basal cell carcinoma with combined laser extirpation and methyl aminolevulinic acid: five-year success rates.

Basal cell carcinoma is the most common cancer. Excisional surgery is associated with a high clearance rate, at the expense of significant functional and aesthetic morbidity, especially within the T-zone or for extensive lesions. We report five-year follow-up outcomes for carbon dioxide laser extirpation of cutaneous basal cell carcinoma, assisted by immediate methyl aminolevulinate photodynamic therapy and cost-benefit considerations. Retrospective cohort database analysis of adult patients with biopsy-proven primary cutaneous basal cell carcinoma, completing five years of follow-up. Direct per-lesion cost was compared with conventional wide local excision. Patients with morphoeic basal cell carcinoma were excluded. Treated lesions were up to 1% total body surface area and up to 3.8mm (1.38 ± 0.695cm, mean ± standard deviation) in biopsy-proven depth. At the five-year follow-up mark, 93.6% of treated areas remained free of recurrence. Nodular basal cell carcinoma was the most common subtype (41.5%). A mean tumour depth greater than 2 ± 0.872mm was significantly associated with recurrence (Mann-Whitney, p = 0.0487). For a service delivered through the NHS at 2015 prices, we report a 43% saving, equating to a saving of £235 per basal cell carcinoma or a national annualised saving of £70 million by 2025 for the NHS. Our results suggest that CO2-assisted photodynamic therapy is non-inferior to excision but may offer better functional and cosmetic preservation at a fraction of the direct like for like cost of operative surgery. Investigation of this method by randomised controlled methodology is warranted.

"Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation": Is it a new variant of sarcomatoid basal cell carcinoma or a collision tumor composed of a myoepithelial carcinoma and an incidental basal cell carcinoma?

"Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation": Is it a new variant of sarcomatoid basal cell carcinoma or a collision tumor composed of a myoepithelial carcinoma and an incidental basal cell carcinoma?

Reply to "Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation. Is it a new variant of sarcomatoid basal cell carcinoma or a collision tumor composed of a myoepithelial carcinoma and an incidental basal cell carcinoma?"

Reply to "Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation. Is it a new variant of sarcomatoid basal cell carcinoma or a collision tumor composed of a myoepithelial carcinoma and an incidental basal cell carcinoma?"

Excisional biopsy of primary and well-defined basal cell carcinoma diagnosed by clinic and- dermoscopy: diagnostic and 118 therapeutic accuracy

Excisional biopsy of primary and well-defined basal cell carcinoma diagnosed by clinic and- dermoscopy: diagnostic and 118 therapeutic accuracy

Multiple primary skin cancer: case report and literature review

Multiple primary form of melanoma is one of the variants of the clinical course of this tumor. Typically two primary lesions are diagnosed and secondary tumor differs much in terms of clinical and pathological characteristics. Besides subsequent melanomas, patients are at higher risk of developing non-melanoma skin cancer, tumors of the breast, prostate gland, kidneys and the gastrointestinal tract. The article describes the case of multiple primary skin cancer, manifested by two primary melanomas and basal cell carcinoma, and literature review on this issue.

Treatment of multiple superficial basal cell carcinomas with topical imiquimod

Basal cell carcinoma is the most common malignancy of man. The use of the topical imiquimod 5% cream offers a noninvasive, nonsurgical, and an effective option for the treatment of primary types superficial basal cell carcinoma (sBCC). We present a case series of patients who used imiquimod 5% cream with good therapeutic effect. The medication had a good tolerability profile and there were no ocular adverse events. Imiquimod 5% cream could be considered the first choice treatment for BCCs in older patients who are poor candidates to surgery.

Prognostic factors in the primary and recurrent high-risk basal cell carcinoma of the face

Prognostic factors in the primary and recurrent high-risk basal cell carcinoma of the face

SU-E-T-277: Modeling Normal Tissue Complication Probability Based On Compiled Clinical Data From Skin Cancer Radiotherapy

Purpose: Our objective is to model normal tissue complication probability (NTCP) based on published clinical data of head/face non‐melanoma skin cancers to determine optimum treatment schemes using advanced radiotherapy (RT) technologies. Methods: Reports citing crude estimates of erythema, desquamation and telangiectasia for primary basal and squamous cell carcinoma (BCC & SCC, resp) of the head/face were used in model development. The models had the form: NTCP = 1/(1+exp(‐(BED + BEDprolif x T — TD50)/k), where BED is the LQ model based biological effective dose. Uncomplicated tumor control functions (UCTCs) were created using NTCP models together with our own separately published TCP models. Values of BED maximizing UCTC were calculated and compared with 5 × 7.2 Gy in one week and 15 × 3 Gy in 3 weeks treatment schedules (BED 14 = 54.5 & 54.6 Gy, respectively). Results: Literature search yield six reports useful in the development of a TCP model for BCC/SCC. The reported a median total dose of 39.0 Gy (range: 23.9–52.4 Gy), dose per fraction of 3.3 Gy/fx (range: 1.7–7.3 Gy/fx), & total treatment time of 28.7 days (range: 12–40 days). Three NTCP and 12 UTCP models were generated for treatments with tumors of size 2cm. Maximum UCTC occurred at biological effective doses (BEDs) ranging from 36.25–52.25 Gy to the BCC/SCC tumors 2 cm in size. Conclusion: Three NTCP models for endpoints observed in skin cancer RT were developed based on published data, which can depend on the size of irradiated skin area (future work will explore the area–NTCP relationship further). BED values for single and multiple fraction treatments were identified to maximize UCTC for tumors > 2 cm in size, though smaller tumors may benefit from treatment schedules with lower BED.

Predictors of Basal Cell Carcinoma in High-Risk Patients in the VATTC (VA Topical Tretinoin Chemoprevention) Trial

Basal cell carcinoma (BCC) is the most common cancer in the United States today, and patients who have had one are likely to have multiple carcinomas over time. Predictors of new BCCs on the face and ears among those at very high risk have not been studied in detail. We sought to do so prospectively in the context of a 6-year trial. We found that the number of BCCs in the prior 5 years was the most important predictor. Age, sun sensitivity, occupational sun exposure before the age of 30 years (but not afterward), lower educational level, history of eczema, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and more sunscreen use in the week, but not the 6 months, before enrollment were also independent predictors, but sunburns, baseline sun exposure, and other sun-protective measures, other skin cancers, and actinic keratoses were not. None of the eczema patients had a history of topical calcineurin use. The cumulative risk of BCC was 55% at 5 years. These findings document the key risk factors in this very high-risk population, suggesting that the history of eczema may increase the risk in those at high risk and that early sun exposure is important even in this group, and underscoring the need for chemopreventive strategies.

Abstract 4090: Epigenetic profiling identifies differentially methylated loci in metastatic vs. non-metastatic primary squamous and basal cell skin cancers

Abstract Nonmelanoma skin cancer is the most commonly diagnosed cancer in the United States. Over 2 million new cases of these cancers are diagnosed each year, and incidence rates are increasing worldwide. Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin are generally considered less aggressive than melanomas, which is reflected in their lower relative mortality rates. Despite this, a clinically relevant subgroup of both of these cancers will metastasize and develop an aggressive disease phenotype. In order to characterize the molecular pathways that may be involved in the development of metastatic disease in these common cancers, we measured DNA methylation profiles at 1505 CpG sites associated with 807 related to cancer using the Illumina Goldengate Methylation Cancer Panel BeadArray in BCCs and SCCs isolated from patients treated at the University of Michigan. DNA methylation was measured in metastatic (n=9) and non-metastatic (n=19) primary SCCs and in metastatic (n=3) and non-metastatic (n=9) primary BCCs. Due to the known divergent mechanisms of carcinogenesis of basal and squamous cell carcinomas, separate analyses were conducted for these tumor types. Unsupervised hierarchical clustering was used to identify overall differences in DNA methylation patterns between metastatic and non-metastatic disease. Gene specific analyses using linear modeling coupled with an empirical Bayes method of variance estimation were conducted to identify if methylation at individual CpG sites is associated with metastatic potential. SCCs were not found to cluster based on metastasis, however, metastatic BCCs were found to cluster together, suggesting that metastatic BCCs may share common mechanisms of pathogenesis. In gene specific analyses, FRZB was found to be statistically significantly hypermethylated in metastatic compared to non-metastatic primary SCCs (median methylation: 54.2% vs. 4.7%; p=3.8x10-5). Two sites in MYCL2 were found to be significantly hypomethylated in metastatic vs. non-metastatic BCCs (3.7% and 4.0% vs. 77.9% and 53.5%; p=1.87x10-6 and 3.69x10-5 respectively). The results from this pilot study give insight into the molecular mechanism of metastasis for nonmelanoma skin cancers and identify the divergent characteristics of BCCs and SCCs. The differentially methylation regions identified in this study may be useful epigenetic biomarkers of metastatic potential for nonmelanoma skin cancers to be examined in an extended patient population in future studies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4090. doi:1538-7445.AM2012-4090

Surgical excision of periocular basal cell carcinomas

The purpose of this study was to determine the histological clearance and clinical recurrence rates following excision of primary periocular biopsy-proven basal cell carcinomas (BCCs) in a teaching hospital in United Kingdom and compare it with other published reports. Records of consecutive patients with a biopsy proven diagnosis of primary periocular BCCs treated surgically at our hospital between 1995 and March 2003 were reviewed. Twenty seven cases (25 patients) were identified. Intra-operative frozen sections (IFS) were performed in 17 (63%) of the cases with clear margins on IFS in 16/17 (94%) of these cases. Histology revealed complete excision in 25/27 (92.5%) of cases. The results of excision of periocular BCCs in our setting particularly with IFS are comparable with other published reports. A reaudit is recommended in 5 years to allow a larger patient population with greater follow up, which would enable us to give more definitive judgment on this treatment modality.

Efficacy of Narrow-Margin Excision of Well-Demarcated Primary Facial Basal Cell Carcinomas

Efficacy of Narrow-Margin Excision of Well-Demarcated Primary Facial Basal Cell Carcinomas

MAL-PDT versus cryotherapy in primary superficial basal cell carcinoma: Results of a 36-month follow-up

MAL-PDT versus cryotherapy in primary superficial basal cell carcinoma: Results of a 36-month follow-up