[Surgical techniques in the treatment of basal cell carcinoma-a prospective investigation].
Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung.
3D histology
Curettage
Dermatologic surgery
Epithelial skin cancer
Recurrence rate
Journal
Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete
ISSN: 1432-1173
Titre abrégé: Hautarzt
Pays: Germany
ID NLM: 0372755
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
pubmed:
16
9
2020
medline:
27
11
2020
entrez:
15
9
2020
Statut:
ppublish
Résumé
Basal cell carcinomas are the most frequent epithelial skin tumors and a frequent indication for dermatological interventions. Despite the establishment of drug treatment options, surgery is still the treatment of choice. Various options are available ranging from curettage to complex dermatosurgical procedures. In addition to the main aspect of low local recurrence rates, esthetic factors and the number of procedures are also important for the choice of treatment. In this study 347 patients with 398 basal cell carcinomas (nodular type, diameter up to 10 mm) were prospectively examined. The patients were randomized into two treatment arms: in one group the tumor was treated by ring curettage and in the other group the tumor was excised. Patients who underwent 3D histologically controlled surgery due to basal cell carcinoma during the same investigation period served as controls. The highest local recurrence rate was observed after curettage (14.0%), whereas the group with 3D histology had the lowest recurrence rate (0.9%, p < 0.001). In the 3D group, more re-excisions were required to achieve complete tumor clearance compared to the group who underwent excisions with serial section histology. Patients rated the esthetic outcome best after curettage. The median follow-up was 3.9 years. The choice of surgical treatment for small nodular basal cell carcinomas depends on individual circumstances. Excisions controlled by 3D histology with wound closure after complete tumor clearance showed the lowest recurrence rate in our study; however, curettage is also a possible surgical treatment option with minimal effort and an acceptable recurrence rate, which can lead to good esthetic results.
Sections du résumé
BACKGROUND
BACKGROUND
Basal cell carcinomas are the most frequent epithelial skin tumors and a frequent indication for dermatological interventions. Despite the establishment of drug treatment options, surgery is still the treatment of choice. Various options are available ranging from curettage to complex dermatosurgical procedures. In addition to the main aspect of low local recurrence rates, esthetic factors and the number of procedures are also important for the choice of treatment.
METHODS
METHODS
In this study 347 patients with 398 basal cell carcinomas (nodular type, diameter up to 10 mm) were prospectively examined. The patients were randomized into two treatment arms: in one group the tumor was treated by ring curettage and in the other group the tumor was excised. Patients who underwent 3D histologically controlled surgery due to basal cell carcinoma during the same investigation period served as controls.
RESULTS
RESULTS
The highest local recurrence rate was observed after curettage (14.0%), whereas the group with 3D histology had the lowest recurrence rate (0.9%, p < 0.001). In the 3D group, more re-excisions were required to achieve complete tumor clearance compared to the group who underwent excisions with serial section histology. Patients rated the esthetic outcome best after curettage. The median follow-up was 3.9 years.
CONCLUSION
CONCLUSIONS
The choice of surgical treatment for small nodular basal cell carcinomas depends on individual circumstances. Excisions controlled by 3D histology with wound closure after complete tumor clearance showed the lowest recurrence rate in our study; however, curettage is also a possible surgical treatment option with minimal effort and an acceptable recurrence rate, which can lead to good esthetic results.
Identifiants
pubmed: 32930855
doi: 10.1007/s00105-020-04685-1
pii: 10.1007/s00105-020-04685-1
pmc: PMC7686215
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
ger
Sous-ensembles de citation
IM
Pagination
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