Histologic subtype of treatment failures after noninvasive therapy for superficial basal cell carcinoma: An observational study.

Autor: van Delft, Lieke C.J., Nelemans, Patty J., Jansen, Maud H.E., Arits, Aimee H.M.M., Roozeboom, Marieke H., Hamid, Myrurgia A., Mosterd, Klara, Kelleners-Smeets, Nicole W.J.
Zdroj: Journal of the American Academy of Dermatology; Apr2019, Vol. 80 Issue 4, p1022-1028, 7p
Abstrakt: Background: There have been concerns that recurrences after noninvasive therapy for basal cell carcinoma (BCC) transform into a "more aggressive" histologic subtype.Objective: We sought to evaluate the proportion of patients with a nonsuperficial treatment failure after noninvasive therapy for superficial BCC.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: 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: There was limited information on the exact time of occurrence of treatment failures.Conclusion: 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. [ABSTRACT FROM AUTHOR]
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