Histologic subtype of treatment failures after noninvasive therapy for superficial basal cell carcinoma: An observational study.
Aged
Aminolevulinic Acid
/ analogs & derivatives
Antimetabolites, Antineoplastic
/ therapeutic use
Antineoplastic Agents
/ therapeutic use
Carcinoma, Basal Cell
/ drug therapy
Equivalence Trials as Topic
Female
Fluorouracil
/ therapeutic use
Humans
Imiquimod
/ therapeutic use
Male
Middle Aged
Photochemotherapy
Photosensitizing Agents
/ therapeutic use
Skin Neoplasms
/ drug therapy
Treatment Failure
5-fluorouracil
MAL-PDT
basal cell carcinoma
histologic subtype
imiquimod
misclassification
noninvasive therapy
sampling error
superficial
transformation
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
18
06
2018
revised:
24
10
2018
accepted:
13
12
2018
pubmed:
26
12
2018
medline:
13
4
2019
entrez:
25
12
2018
Statut:
ppublish
Résumé
There have been concerns that recurrences after noninvasive therapy for basal cell carcinoma (BCC) transform into a "more aggressive" histologic subtype. We sought to evaluate the proportion of patients with a nonsuperficial treatment failure after noninvasive therapy for superficial BCC. An observational study was performed using data from a single blind, noninferiority, randomized controlled trial (March 2008-August 2010) with 5-year follow-up in patients with primary superficial BCC treated with methylaminolevulinate-photodynamic therapy, 5-fluorouracil, or imiquimod. Data were used from 166 adults with a histologically confirmed treatment failure. A nonsuperficial subtype was found in 64 of 166 treatment failures (38.6%). Proportions with a more aggressive subtype than the primary tumor were 51.3% (38/74) for early and 28.3% (26/92) for later treatment failures (P = .003). The proportion of more aggressive early failures was significantly lower after imiquimod (26.3%) compared with methylaminolevulinate-photodynamic therapy (54.8%, P = .086) and 5-fluorouracil (66.7%, P = .011). There was limited information on the exact time of occurrence of treatment failures. More aggressive treatment failure recurrences after noninvasive therapy for superficial BCC occur most often within the first 3 months posttreatment, probably indicating underdiagnosis of more aggressive components in the primary tumor rather than transformation.
Sections du résumé
BACKGROUND
BACKGROUND
There have been concerns that recurrences after noninvasive therapy for basal cell carcinoma (BCC) transform into a "more aggressive" histologic subtype.
OBJECTIVE
OBJECTIVE
We sought to evaluate the proportion of patients with a nonsuperficial treatment failure after noninvasive therapy for superficial BCC.
METHODS
METHODS
An observational study was performed using data from a single blind, noninferiority, randomized controlled trial (March 2008-August 2010) with 5-year follow-up in patients with primary superficial BCC treated with methylaminolevulinate-photodynamic therapy, 5-fluorouracil, or imiquimod. Data were used from 166 adults with a histologically confirmed treatment failure.
RESULTS
RESULTS
A nonsuperficial subtype was found in 64 of 166 treatment failures (38.6%). Proportions with a more aggressive subtype than the primary tumor were 51.3% (38/74) for early and 28.3% (26/92) for later treatment failures (P = .003). The proportion of more aggressive early failures was significantly lower after imiquimod (26.3%) compared with methylaminolevulinate-photodynamic therapy (54.8%, P = .086) and 5-fluorouracil (66.7%, P = .011).
LIMITATIONS
CONCLUSIONS
There was limited information on the exact time of occurrence of treatment failures.
CONCLUSION
CONCLUSIONS
More aggressive treatment failure recurrences after noninvasive therapy for superficial BCC occur most often within the first 3 months posttreatment, probably indicating underdiagnosis of more aggressive components in the primary tumor rather than transformation.
Identifiants
pubmed: 30582993
pii: S0190-9622(18)33100-1
doi: 10.1016/j.jaad.2018.12.028
pii:
doi:
Substances chimiques
Antimetabolites, Antineoplastic
0
Antineoplastic Agents
0
Photosensitizing Agents
0
methyl 5-aminolevulinate
585NM85KYM
Aminolevulinic Acid
88755TAZ87
Imiquimod
P1QW714R7M
Fluorouracil
U3P01618RT
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1022-1028Informations de copyright
Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.