Pulmonary metastasis from a basal-cell carcinoma of the retroauricular region

Metastatic basal cell carcinoma: prognosis dependent on anatomic site and spread of disease

PURPOSE

This review provides a description of the epidemiology and survival outcomes for cases with metastatic basal cell carcinoma (mBCC) based on published reports (1981-2011).

METHODS

A literature search (MEDLINE via PubMed) was conducted for mBCC case reports published in English: 1981-2011. There were 172 cases that met the following criteria: primary BCC located on skin, metastasis confirmed by pathology and metastasis not resulting from direct tumour spread. From these, 100 mBCC cases with explicit information on follow-up time were selected for analysis. Survival analysis was conducted using Kaplan-Meier methods.

RESULTS

Among 100 mBCC cases selected for analysis, including one case with Gorlin syndrome, 50% had regional metastases (RM) and 50% had distant metastases (DM). Cases with DM were younger at mBCC diagnosis (mean age, 58.0 versus 66.3 years for RM; P=0.0013). Among 93 (of 100) cases with treatment information for metastatic disease, more DM cases received chemotherapy (36.2% versus 6.5% for RM), but more RM cases underwent surgery (87.0% versus 40.4% for DM). Among all 100 cases, median survival after mBCC diagnosis was 54 months (95% confidence interval (CI), 24-72), with shorter survival in DM (24 months; 95% CI, 12-35) versus RM cases (87 months; 95% CI, 63-not evaluable).

CONCLUSION

Cases with RM and DM mBCC may have different clinical courses and outcomes. Based on published reports, DM cases were younger at mBCC diagnosis, with shorter median survival than RM cases. This study provides a historical context for emerging mBCC treatments.

Evaluation of clinical prognostic factors in T1 N0 M0 head and neck basal cell carcinoma

This retrospective study was carried out to assess the clinical outcome of stage I (ie, T1 N0 M0) head and neck basal cell carcinoma (HNBCC) and verify the impact of some clinical parameters on prognosis. The cases of 220 patients with stage I (ie, T1 N0 M0) histologically proven HNBCC were analyzed.The global disease-specific survival rate at 36 months was 100%, irrespective of the type of surgery, and thus, it was demonstrated that radical tumor resection is a viable procedure for stage I HNBCC. However, 11 (5%) of 220 cases had a recurrence. A second procedure was performed in 10 (90.9%) of 11 cases. In 3 of the 10 patients operated on twice (30%), a second recurrence was detected. Thus, a second surgical procedure on a recurring tumor is possible, but the multimodality treatment regimen should be considered for recurring tumors.