Mohs micrographic surgery for basal cell carcinoma: evaluation of the indication criteria and predictive factors for extensive subclinical spread
| Autor: | K. Lapiere, A. Batteauw, Katia Ongenae, G. Van Maele, Isabelle Hoorens, Barbara Boone |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Skin Neoplasms medicine.medical_treatment Dermatology 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Mohs surgery Carcinoma Medicine Humans Basal cell carcinoma Prospective Studies Prospective cohort study Subclinical infection Aged Aged 80 and over business.industry organic chemicals Incidence (epidemiology) fungi Histology Middle Aged medicine.disease Mohs Surgery Treatment Outcome Carcinoma Basal Cell 030220 oncology & carcinogenesis Female Skin cancer Facial Neoplasms Neoplasm Recurrence Local business |
| Zdroj: | The British journal of dermatology. 174(4) |
| ISSN: | 1365-2133 |
| Popis: | SummaryBackground The incidence of basal cell carcinoma (BCC) is rising and BCC treatment has an important impact on healthcare budget. Mohs micrographic surgery (MMS) has the highest 5-year cure rate but is an expensive technique. Objectives To study the indication criteria for MMS, using a series of 1062 patients treated for facial BCCs between 1998 and 2011. Methods The accuracy of the indication criteria was evaluated by comparing the characteristics of BCC requiring one vs. more than one round of MMS. Predictors for extensive subclinical spread (three or more rounds) were examined using the preoperative patient and all tumour characteristics. Results BCCs with a surface > 1 cm2 and aggressive histology (morphoeaform and micronodular), and a patient age > 80 years are strong predictors for two or more rounds of MMS being required. Extensive subclinical spread was present in recurrent tumours, morphoeaform BCC or BCC with mixed histology. Conclusions We found that tumour size and aggressive histology are the strongest indication criteria for MMS. Recurrence and aggressive histology are predictors for extensive subclinical spread but not for two or more rounds of MMS. Evidence-based indications for MMS are necessary to ensure cost-effective management of BCC. |
| Databáze: | OpenAIRE |
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