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Kunstfeld R, Nguyen VA. New therapeutic developments for basal cell carcinoma. J Dtsch Dermatol Ges 2023; 21:382-385. [PMID: 37070499 DOI: 10.1111/ddg.15020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/22/2023] [Indexed: 04/19/2023]
Abstract
In 2013, systemic therapy was introduced into the treatment of locally advanced (laBCC) and metastatic basal cell carcinoma (mBCC). Meanwhile, immunotherapy has been approved in this indication as well. Additional immunotherapies and other classes of drugs including combination regimens are currently being investigated in clinical trials. These agents might considerably expand the therapeutic armamentarium for laBCC and mBCC in the future.
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Affiliation(s)
- Rainer Kunstfeld
- University Hospital for Dermatology, Medical University Vienna, Vienna, Austria
| | - Van Anh Nguyen
- University Hospital for Dermatology, Venereology and Allergology, Medical University Innsbruck, Innsbruck, Austria
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2
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Lütgerath C, Weiß C, Böer‐Auer A. Klinisch‐pathologische Merkmale und histologische Tumorreste in Reexzisionspräparaten unvollständig resezierter Basalzellkarzinome. J Dtsch Dermatol Ges 2022; 20:1476-1484. [DOI: 10.1111/ddg.14884_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022]
Affiliation(s)
| | - Christel Weiß
- Medizinische Statistik Biomathematik und Informationsverarbeitung Universitätsmedizin Mannheim
| | - Almut Böer‐Auer
- Dermatologikum Hamburg GmbH Hamburg
- Klinik für Hautkrankheiten Universitätsklinikum Münster
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3
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Lütgerath C, Weiß C, Böer‐Auer A. Clinicopathological features and histological tumor residues in re‐excision specimens of incompletely resected basal cell carcinomas. J Dtsch Dermatol Ges 2022; 20:1476-1483. [DOI: 10.1111/ddg.14884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/29/2022] [Indexed: 11/06/2022]
Affiliation(s)
| | - Christel Weiß
- Department of Medical Statistics and Biomathematics University Medical Centre Mannheim Germany
| | - Almut Böer‐Auer
- Dermatologikum Hamburg GmbH Hamburg Germany
- Department of Dermatology University Medical Centre Münster Germany
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4
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Cocuz IG, Cocuz ME, Sabău AH, Niculescu R, Tinca AC, Vunvulea V, Budin CE, Șincu MC, Popelea MC, Cotoi OS. An Up-to-Date Correlation of Epidemiological and Histopathological Characteristics of Basal Cell Carcinoma of the Skin in a County Hospital in Romania. Dermatopathology (Basel) 2022; 9:183-195. [PMID: 35735659 PMCID: PMC9221858 DOI: 10.3390/dermatopathology9020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Basal carcinoma of the skin (BCC) is part of the nonmelanoma skin cancer (NMSC) family and is the most frequently occurring type of skin cancer in humans. A combination of clinical and histopathological approaches is necessary in order to establish the best treatment regime for patients who have been diagnosed with this type of cancer. The objective of the present study was to establish the statistical value of prediction for certain sociodemographic characteristics (age category and environment of origin) and histopathological parameters of the subjects that could be related to the incidence of diagnosis with certain histopathological subtypes of BCC. Materials and Methods: In order to verify the veracity of the established research hypotheses, we conducted a retrospective study based on the histopathological reports of 216 patients who were treated at the Pathology Department of Mureș Clinical County Hospital. Results: Cystic BCC is higher in patients who are older than 71 years of age, and the superficial multicentric and keratotic subtypes are more frequently diagnosed in urban areas. Patients who have been diagnosed with the superficial multicentric BCC subtype are not usually very old in contrast to the patients who tend to be diagnosed with the cystic BCC subtype. The nodular BCC subtype is positively associated with ulceration (p = 0.004); the superficial multicentric BCC subtype is positively associated with intra- and peritumoral inflammatory infiltrate (p = 0.022, p = 0.034) and negatively associated with ulceration (r = -0.218, p = 0.001). The infiltrative BCC subtype is positively associated with ulceration (p = 0.021), and the keratotic BCC subtype is positively associated with peritumoral inflammatory infiltrate (p = 0.02). Conclusions: Depending on each patient's epidemiological and sociodemographic data, a pattern can be established regarding the appropriate clinical and treatment approaches for that patient, which can be supported based on the implications of the histopathological diagnostic. This can lead to an improvement in the patient's quality of life and increased satisfaction with the provided medical services.
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Affiliation(s)
- Iuliu Gabriel Cocuz
- Doctoral School of Medicine and Pharmacy, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (M.C.Ș.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (A.-H.S.); (R.N.); (A.C.T.); (M.C.P.); (O.S.C.)
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Maria Elena Cocuz
- Fundamental Prophylactic and Clinical Disciplines Department, Faculty of Medicine, Transilvania University of Brasov, 500003 Brașov, Romania
- Clinical Pneumology and Infectious Diseases Hospital of Brasov, 500118 Brasov, Romania
- Correspondence:
| | - Adrian-Horațiu Sabău
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (A.-H.S.); (R.N.); (A.C.T.); (M.C.P.); (O.S.C.)
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Raluca Niculescu
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (A.-H.S.); (R.N.); (A.C.T.); (M.C.P.); (O.S.C.)
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Andreea Cătălina Tinca
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (A.-H.S.); (R.N.); (A.C.T.); (M.C.P.); (O.S.C.)
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Vlad Vunvulea
- Anatomy and Embryology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Corina Eugenia Budin
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Mihaela Cornelia Șincu
- Doctoral School of Medicine and Pharmacy, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (M.C.Ș.)
| | - Maria Cătălina Popelea
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (A.-H.S.); (R.N.); (A.C.T.); (M.C.P.); (O.S.C.)
| | - Ovidiu Simion Cotoi
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania; (A.-H.S.); (R.N.); (A.C.T.); (M.C.P.); (O.S.C.)
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
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5
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoscopically narrowed surgical margins for head and neck basal cell carcinoma: A retrospective case-control study. J Dtsch Dermatol Ges 2022; 20:807-816. [PMID: 35581699 PMCID: PMC9321004 DOI: 10.1111/ddg.14757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) can cause extensive tissue damage if untreated. Complete surgical excision is the treatment of choice, but especially in the head-and neck area, defining both radical and healthy skin sparing surgical margins is complex. MATERIALS AND METHODS Excised, small (≤ 1 cm), BCCs of the head and neck were retrospectively analyzed, comparing histological properness of surgical margins after clinical-dermatoscopical preoperative evaluation (cases), vs. clinical evaluation only (controls) and recurrences. RESULTS Of 281 BCCs: 6 % (8/139) of cases and 8 % (12/142) of controls had unproper deep margins; 4 % (5/139) of cases, 20 % (29/142) of controls had unproper lateral margins (P < 0.001). Surgical 3 mm lateral margins were unproper in 0 % (15/66) of cases, 15 % (10/66) of controls (P > 0.005); surgical 1-2 mm lateral margins were unproper in 7 % (5/73) of cases, 25 % (19/76) of controls (P < 0.01). Of cases excised at 3 mm, 1-2 mm, and controls, 1.5 %, 0 %, and 7.7 % recurred, respectively. CONCLUSIONS BCC excision at 3 mm may be appropriate in the head and neck for small, dermatoscopically well-defined and non-aggressive BCCs, attaining surgical cure rates of 100 % and 1.5 % recurrences. Excision at 1-2 mm should be reserved only for BCCs in very difficult-to-treat areas, as the surgical cure rate was only 93 %.
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Affiliation(s)
- Astrid Herzum
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Martina Burlando
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Pietro Paolo Tavilla
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Claudia Micalizzi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Mattia Fabio Molle
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Emanuele Cozzani
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
| | - Aurora Parodi
- Department of DermatologyDi.S.Sal.University of GenoaSan Martino Polyclinic Hospital IRCCSGenoaItaly
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Herzum A, Burlando M, Tavilla PP, Micalizzi C, Molle MF, Cozzani E, Parodi A. Dermatoskopisch kontrollierte, schmalere Resektionsränder bei Basalzellkarzinomen an Kopf und Hals: Retrospektive Fallkontrollstudie. J Dtsch Dermatol Ges 2022; 20:807-817. [PMID: 35711047 DOI: 10.1111/ddg.14757_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Hintergrund: Unbehandelt kann das Basalzellkarzinom (BCC) erhebliche Gewebezerstörungen verursachen. Die komplette chirurgische Exzision ist die Behandlung der Wahl. Allerdings stellt es besonders im Gesichts- und Halsbereich eine Herausforderung dar, den Tumor vollständig zu entfernen und möglichst viel gesundes Gewebe zu erhalten. Material und Methoden: Bereits exzidierte kleine BCC (≤ 1 cm) von Kopf oder Hals wurden retrospektiv analysiert. Verglichen wurde die histologisch kontrolliert angemessene Breite des Resektionsrandes nach präoperativer dermatoskopischer Untersuchung (Fälle) im Vergleich zur rein klinischen Untersuchung (Kontrollen), sowie die Rezidivrate. Ergebnisse: Bei 281 BCC: 6 % (8/139) der Fälle und 8 % (12/142) der Kontrollen zeigten inadäquate basale Resektionsränder; 4 % (5/139) der Fälle und 20 % (29/142) der Kontrollen zeigten inadäquate laterale Resektionsränder (P < 0.001). Laterale Resektionsränder von 3 mm waren in 0 % (15/66) der Fälle, jedoch in 15 % (10/66) der Kontrollen inadäquat (P >0.005); laterale Resektionsränder von 1-2 mm waren in 7 % (5/73) der Fälle und in 25 % (19/76) der Kontrollen inadäquat (P < 0.01). Rezidive traten in den Fällen mit 3 mm Resektionsrand in 1,5 % auf, in den Fällen mit 1-2 mm Resektionsrand bei 0 %, und bei den Kontrollen bei 7,7 %. Schlussfolgerung: Für BCC im Kopf- und Halsbereich erscheint ein Resektionsrand von 3 mm angemessen, sofern das BCC klein, dermatoskopisch gut definiert und wenig aggressiv ist. Hier zeigten sich operative Heilungsraten von 100 % mit 1,5 % Rezidiven. Resektionsränder von 1-2 mm sollten nur für BCC in sehr schwierig zu behandelnden Bereichen in Betracht gezogen werden, da die Heilungsrate hier nur bei 93 % lag.
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Affiliation(s)
- Astrid Herzum
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Martina Burlando
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Pietro Paolo Tavilla
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Claudia Micalizzi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Mattia Fabio Molle
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Emanuele Cozzani
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
| | - Aurora Parodi
- Abteilung Dermatologie, Di.S.Sal., Universität Genua, San Martino Polyclinic Hospital IRCCS, Genua, Italien
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7
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Steeb T, Reinhardt L, Harlaß M, Heppt MV, Meier F, Berking C. Assessment of the Quality, Understandability, and Reliability of YouTube Videos as a Source of Information on Basal Cell Carcinoma: Web-Based Analysis. JMIR Cancer 2022; 8:e29581. [PMID: 35275067 PMCID: PMC8956995 DOI: 10.2196/29581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/07/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background Patients with skin cancer increasingly watch online videos to acquire disease-related information. Until now, no scientific evaluation of the quality of videos available for German-speaking patients with basal cell carcinoma (BCC) has been performed. Objective In this study, we aimed to identify and evaluate videos about BCC provided on YouTube. Methods A video search on YouTube was conducted in July 2020, using German BCC-related keywords (eg, “Basalzellkarzinom,” “Basaliom,” “weißer hautkrebs,” and “heller hautkrebs”). The first three pages (ie, 60 videos) were searched by two independent researchers for each keyword. Two authors evaluated videos that met the predefined eligibility criteria. The quality of the information of the videos was evaluated using the DISCERN tool and the Global Quality Scale (GQS). The understandability and actionability were assessed with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). The reliability was assessed with the JAMA (Journal of the American Medical Association) criteria score. Subgroup differences were identified using the Kruskal-Wallis test. Results A total of 41 videos were included in the evaluation. The mean assessment scores were as follows: DISCERN, 3.3 (SD 0.80); GQS, 3.8 (SD 1.1); JAMA, 27.74% (SD 22.1%); understandability, 70.8% (SD 13.3%); and actionability, 45.9% (SD 43.7%). These values indicated that the videos were of medium to good quality and had good understandability, low actionability, and poor reliability. The quality of videos provided by health professionals was significantly higher than that of videos provided by laypersons. Conclusions Optimization of health-related videos about BCC is desirable. In particular, adaptation to reliability criteria is necessary to support patient education and increase transparency.
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Affiliation(s)
- Theresa Steeb
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
| | - Lydia Reinhardt
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Matthias Harlaß
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
| | - Markus Vincent Heppt
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
| | - Friedegund Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Carola Berking
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - Europäische Metropolregion Nürnberg, Erlangen, Germany
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8
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Fuchs CSK, Ortner VK, Mogensen M, Rossi AM, Pellacani G, Welzel J, Mosterd K, Guitera P, Nayahangan LJ, Johnsson VL, Haedersdal M, Tolsgaard MG. 2021 international consensus statement on optical coherence tomography for basal cell carcinoma: image characteristics, terminology and educational needs. J Eur Acad Dermatol Venereol 2022; 36:772-778. [PMID: 35141952 DOI: 10.1111/jdv.17969] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/02/2021] [Accepted: 01/07/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the widespread use of optical coherence tomography (OCT) for imaging of keratinocyte carcinoma, we lack an expert consensus on the characteristic OCT features of basal cell carcinoma (BCC), an internationally vetted set of OCT terms to describe various BCC subtypes, and an educational needs assessment. OBJECTIVES To identify relevant BCC features in OCT images, propose terminology based on inputs from an expert panel and identify content for a BCC-specific curriculum for OCT trainees. METHODS Over three rounds, we conducted a Delphi consensus study on BCC features and terminology between March and September 2020. In the first round, experts were asked to propose BCC subtypes discriminable by OCT, provide OCT image features for each proposed BCC subtypes and suggest content for a BCC-specific OCT training curriculum. If agreement on a BCC-OCT feature exceeded 67%, the feature was accepted and included in a final review. In the second round, experts had to re-evaluate features with less than 67% agreement and rank the ten most relevant BCC OCT image features for superficial BCC, nodular BCC and infiltrative and morpheaphorm BCC subtypes. In the final round, experts received the OCT-BCC consensus list for a final review, comments and confirmation. RESULTS The Delphi included six key opinion leaders and 22 experts. Consensus was found on terminology for three OCT BCC image features: (i) hyporeflective areas, (ii) hyperreflective areas and (iii) ovoid structures. Further, the participants ranked the ten most relevant image features for nodular, superficial, infiltrative and morpheaform BCC. The target group and the key components for a curriculum for OCT imaging of BCC have been defined. CONCLUSION We have established a set of OCT image features for BCC and preferred terminology. A comprehensive curriculum based on the expert suggestions will help implement OCT imaging of BCC in clinical and research settings.
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Affiliation(s)
- C S K Fuchs
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - V K Ortner
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M Mogensen
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - A M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - J Welzel
- Department of Dermatology, General Hospital Augsburg, Augsburg, Germany
| | - K Mosterd
- Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW Research Institute for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - P Guitera
- Melanoma Institute Australia, Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - L J Nayahangan
- Copenhagen Academy for Medical Education and Simulation, Centre for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark
| | - V L Johnsson
- Copenhagen Academy for Medical Education and Simulation, Centre for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark
| | - M Haedersdal
- Department of Dermatology and Wound Healing Centre, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M G Tolsgaard
- Copenhagen Academy for Medical Education and Simulation, Centre for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark
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9
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Hoffmann JC, Schön MP. Integrin α E(CD103)β 7 in Epithelial Cancer. Cancers (Basel) 2021; 13:6211. [PMID: 34944831 PMCID: PMC8699740 DOI: 10.3390/cancers13246211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 01/22/2023] Open
Abstract
Interactions of both the innate and the adaptive immune system with tumors are complex and often influence courses and therapeutic treatments in unanticipated ways. Based on the concept that CD8+T cells can mediate important antitumor effects, several therapies now aim to amplify their specific activity. A subpopulation of CD8+ tissue-resident T lymphocytes that express the αE(CD103)β7 integrin has raised particular interest. This receptor presumably contributes to the recruitment and retention of tumor-infiltrating immune cells through interaction with its ligand, E-cadherin. It appears to have regulatory functions and is thought to be a component of some immunological synapses. In TGF-rich environments, the αE(CD103)β7/E-cadherin-interaction enhances the binding strength between tumor cells and infiltrating T lymphocytes. This activity facilitates the release of lytic granule contents and cytokines as well as further immune responses and the killing of target cells. Expression of αE(CD103)β7 in some tumors is associated with a rather favorable prognosis, perhaps with the notable exception of squamous cell carcinoma of the skin. Although epithelial skin tumors are by far the most common tumors of fair-skinned people, there have been very few studies on the distribution of αE(CD103)β7 expressing cells in these neoplasms. Given this background, we describe here that αE(CD103)β7 is scarcely present in basal cell carcinomas, but much more abundant in squamous cell carcinomas with heterogeneous distribution. Notwithstanding a substantial number of studies, the role of αE(CD103)β7 in the tumor context is still far from clear. Here, we summarize the essential current knowledge on αE(CD103)β7 and outline that it is worthwhile to further explore this intriguing receptor with regard to the pathophysiology, therapy, and prognosis of solid tumors.
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Affiliation(s)
- Johanna C. Hoffmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Michael P. Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, 37075 Göttingen, Germany;
- Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, 37075 Göttingen, Germany
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10
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Line-Field Confocal Optical Coherence Tomography May Enhance Monitoring of Superficial Basal Cell Carcinoma Treated with Imiquimod 5% Cream: A Pilot Study. Cancers (Basel) 2021; 13:cancers13194913. [PMID: 34638396 PMCID: PMC8507996 DOI: 10.3390/cancers13194913] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 12/12/2022] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a novel, non-invasive technique for real-time skin imaging. Imiquimod (IQ) 5% cream is an immune response modifier currently approved for the treatment of small, superficial basal cell carcinoma (BCC). The aim of this study was to investigate if LC-OCT may be useful to enhance the treatment monitoring of BCC. Twenty superficial BCCs from 12 patients were treated with IQ 5% cream once daily, five days a week, for six weeks. Clinical and LC-OCT evaluations were performed at baseline and 4 weeks after the end of treatment. At the end of the study, 13 lesions showed a complete clinical and LC-OCT response, 4 lesions a partial clinical and LC-OCT response, and 3 lesions a complete clinical response but residual tumoral signs at LC-OCT. Our pilot study suggests that LC-OCT may represent a promising tool able to enhance the evaluation of the treatment response of BCCs to non-invasive treatments. In our case series, its use highlighted, through a detailed, fast, and complete examination of the treated area, three cases of residual BCC that otherwise would have gone undetected at clinical examination. Future studies on larger series of patients treated with different modalities and with a longer follow-up are advisable.
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11
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Known and new facts on basal cell carcinoma. J Dtsch Dermatol Ges 2021; 19:1021-1041. [PMID: 34288482 PMCID: PMC8361778 DOI: 10.1111/ddg.14580] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022]
Abstract
Basal cell carcinoma (BCC) is the most common malignant tumor in light‐skinned people and amounts to about 75 % of all cases of skin cancer. Increasing incidence rates have been reported for decades all over the world. The main risk factors include UV radiation, male sex, light skin type, advanced age, long‐term immunosuppression, a positive individual or family history, and certain genodermatoses. BCC metastasizes only rarely, and its mortality is low, but it is associated with significant morbidity. Genetic mutations especially in the hedgehog pathway play an important role in BCC pathogenesis. Non‐invasive procedures such as optical coherence tomography or confocal laser scan microscopy are increasingly utilized for diagnostics in addition to visual inspection and dermatoscopy, but only in exceptional cases can histological confirmation of the diagnosis be dispensed with. Various clinical and histological subtypes have been defined. Differentiating between BCC with high and low risk of recurrence has a significant influence on the choice of treatment. Most BCC can be treated effectively and safely with standard surgery, or in selected cases with topical treatment. Locally advanced and metastasized BCC must be treated with radiation or systemic therapy. Radiation is also an option for older patients with contraindications for surgery. The hedgehog inhibitors vismodegib and sonidegib are currently approved for systemic therapy of BCC in Europe. Approval for the PD1 inhibitor cemiplimab as second‐line therapy is expected in the near future.
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Affiliation(s)
- Magdalena Seidl-Philipp
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nina Frischhut
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Nicole Höllweger
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Matthias Schmuth
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
| | - Van Anh Nguyen
- University Hospital for Dermatology, Venereology, and Allergology, Medical University Innsbruck, Austria
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12
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Seidl-Philipp M, Frischhut N, Höllweger N, Schmuth M, Nguyen VA. Bekanntes und Neues zum Basalzellkarzinom. J Dtsch Dermatol Ges 2021; 19:1021-1043. [PMID: 34288462 DOI: 10.1111/ddg.14580_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/02/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Magdalena Seidl-Philipp
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Nina Frischhut
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Nicole Höllweger
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Matthias Schmuth
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
| | - Van Anh Nguyen
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Österreich
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13
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Castanheira A, Vieira MJ, Pinto M, Dias C, Prada L, Macedo S, Fernandes MS, Vieira F, Soares P, Mota A, Lopes JM, Boaventura P. TERTp mutations and p53 expression in head and neck cutaneous basal cell carcinomas with different aggressive features. Sci Rep 2021; 11:10395. [PMID: 34001963 PMCID: PMC8129122 DOI: 10.1038/s41598-021-89906-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/04/2021] [Indexed: 02/07/2023] Open
Abstract
Cutaneous basal cell carcinoma (cBCC) is an economic burden to health services, due to its great morbidity and increasing incidence in old people. Infiltrative cBCCs and cBCCs with micronodular pattern are considered as more aggressive. The role of p53 expression and TERTp mutation on cBCC behavior remains to be clarified. We aimed to assess TERTp mutations and p53 expression in relation to the cBCC histological subtype in a cohort of patients referred to an ENT Department of a tertiary Hospital of Northern Portugal. We performed a retrospective clinicopathological and histological review of the head and neck cBCCs followed-up at the otorhinolaryngology department of Trás-os-Montes e Alto Douro hospital (January 2007–June 2018). We assessed TERTp mutations in 142 cBCCs and p53 protein expression, through immunohistochemistry, in 157 cBCCs. We detected TERTp mutations in 43.7% of cBCCs and p53 overexpression in 60.5% of cBCCs. We spotted association of p53 overexpression and TERTp mutation with necrosis. In the infitrative-growth pattern cBCCs, there was no significant association with the clinical and histological features evaluated, except for necrosis. In the indolent-growth cBCCs, we identified a significant association of TERTp mutation status with female sex, necrosis, multiple cBCCs, and p53 positive expression. Our results suggest that TERTp mutation may be useful to identify more aggressive features in the indolent-growth pattern cBCCs (nodular and superficial subtypes). Further studies with larger cohorts are warranted to clarify the relevance of TERTp mutation in cBCCs.
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Affiliation(s)
- António Castanheira
- Department of Otorhinolaryngology, Centro Hospitalar de Trás-Os-Montes e Alto Douro, Vila Real, Portugal.,FMUP-Faculty of Medicine, University of Porto, Porto, Portugal
| | - Maria João Vieira
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | - Mafalda Pinto
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | - Carolina Dias
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | - Luísa Prada
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisboa, Portugal
| | - Sofia Macedo
- IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | | | | | - Paula Soares
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal.,IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal
| | - Alberto Mota
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Dermatology, Centro Hospitalar São João, Porto, Portugal
| | - José Manuel Lopes
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal.,IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.,Department of Pathology, Centro Hospitalar São João, Porto, Portugal
| | - Paula Boaventura
- FMUP-Faculty of Medicine, University of Porto, Porto, Portugal. .,IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal. .,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
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Grupp M, Illes M, Mentzel J, Simon JC, Paasch U, Grunewald S. Schnittrandkontrolle von Basalzellkarzinomen mittels
ex‐vivo
konfokaler Laserscanmikroskopie mit digitaler Farbbearbeitung – Anwendung in der Routinediagnostik. J Dtsch Dermatol Ges 2021; 19:685-693. [PMID: 33979047 DOI: 10.1111/ddg.14374_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Margarethe Grupp
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Monica Illes
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Julia Mentzel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Jan C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Uwe Paasch
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
| | - Sonja Grunewald
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig AöR, Leipzig
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15
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Grupp M, Illes M, Mentzel J, Simon JC, Paasch U, Grunewald S. Routine application of ex vivo confocal laser scanning microscopy with digital staining for examination of surgical margins in basal cell carcinomas. J Dtsch Dermatol Ges 2021; 19:685-692. [PMID: 33768732 DOI: 10.1111/ddg.14374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Ex vivo confocal laser scanning microscopy (CLSM) allows histologic examination of native tissue based on tissue reflection and nuclear fluorescence staining. The newly introduced digital staining process almost perfectly mimics conventional hematoxylin and eosin (HE) slides. The aim was to evaluate the new method in clinical routine, with regard to quality of findings and time requirements, in the examination of surgical margins of basal cell carcinomas. PATIENTS AND METHODS 78 patients with 101 basal cell carcinomas were prospectively enrolled. Surgery was performed either with complete margin control (n = 60) or as elliptical excision (n = 41). Immediately after excision specimens were scanned with CLSM and then routinely processed by conventional histopathology. Blinded evaluation of images and slides was performed by a dermatopathologist. RESULTS Basal cell carcinomas were excellently recognizable by CLSM directly after excision, and the use of digital staining did not require any adjustment of the examiner's visualization preferences. CLSM images showed a sensitivity of 73.6 % and a specificity of 96.5 % compared to conventional HE stained slides. Erroneous findings were often due to limited assessment potential in cases where the epidermis could not be fully visualized. CONCLUSIONS CLSM with digital HE staining is very well suited to diagnose basal cell carcinomas and their incision margins even under routine conditions and thus represents a tissue-saving alternative to rapid cryostat sectioning.
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Affiliation(s)
- Margarethe Grupp
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Monica Illes
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Julia Mentzel
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Jan C Simon
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Uwe Paasch
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
| | - Sonja Grunewald
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig AöR, Leipzig, Germany
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16
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Kofler L, Breuninger H, Schreiber RH, Eichner M, Häfner HM, Schnabl SM. Three-dimensional histology vs. serial section histology in the treatment of primary basal cell carcinoma: a randomized, prospective, blinded study of 569 tumours. J Eur Acad Dermatol Venereol 2021; 35:1323-1330. [PMID: 33539573 DOI: 10.1111/jdv.17155] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND For basal cell carcinoma (BCC), only few controlled data have been published so far, which directly compare micrographically controlled surgery with conventional serial section histology. In addition to Mohs surgery, which uses cryostat sections, also three-dimensional histology (3D-histology), based on paraffin sections, is available to ensure complete control of the margins and basic sections. OBJECTIVES To investigate the rate of local recurrence (LR) as well as the number of required re-excisions for basal cell carcinomas with serial section histology vs. 3D-histology. METHODS We compared serial sections histology with 3D-histology in a prospective, randomized, controlled blinded trial and analysed 569 BCC of all subtypes up to 30 mm diameter, 287 BCC in the 3D group and 282 BCC in the serial section group. Excisions were performed with adapted primary resection margin according to location and size of the tumour. Surgeons were blinded at the time of surgery as they did not know which histological method will be used. Both methods used paraffin sections. RESULTS Both groups did not differ regarding patients age, tumour location, tumour diameter, tumour subtypes or primary resection margins. In the serial section group, re-excisions were required in 21%; 24 tumours (8.4%) recurred after a median of 2.2 years. In the 3D-histology group, re-excisions were required in 39%; 10 tumours recurred (3.5%) after a median of 2.8 years. The recurrence rates differed significantly between both groups. Mean follow-up was 4.5 years. CONCLUSIONS 3D-histology is a useful technique to detect tumour outgrowths at the excision margins, but required a high rate of re-excisions. 3D-histology was associated with a significantly lower LR rate than serial section histology.
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Affiliation(s)
- L Kofler
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
| | - H Breuninger
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
| | - R H Schreiber
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
| | - M Eichner
- Institute of Clinical Epidemiology and Applied Biometry, Eberhard-Karls University, Tübingen, Germany
| | - H-M Häfner
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
| | - S M Schnabl
- Department of Dermatology, Eberhard-Karls University, Tübingen, Germany
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17
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Fidelis MC, Stelini RF, Staffa LP, Moraes AMD, Magalhães RF. Basal cell carcinoma with compromised margins: retrospective study of management, evolution, and prognosis. An Bras Dermatol 2020; 96:17-26. [PMID: 33288370 PMCID: PMC7838108 DOI: 10.1016/j.abd.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/09/2020] [Indexed: 11/21/2022] Open
Abstract
Background Non-melanoma skin cancer is the most common type of malignancy in the Western world, and surgical excision is the preferred approach. The approach adopted in the face of incomplete excisions of basal cell carcinoma is still controversial. Objectives To compare the number of tumor recurrences after treatment for incompletely excised basal cell carcinoma. Methods Selection and statistical analysis of medical records of patients who had compromised margins after excision of basal cell carcinoma in a tertiary hospital from 2008 to 2013. Results A total of 120 medical records were analyzed; the mean age was 69.6 years, and 50% of the patients were female. The most prevalent histological type was nodular; the mean size was 1.1 cm, and the tumor location with the highest incidence was the nose. The lateral margin was the most frequently positive. Clinical follow-up was more widely adopted; only 40 patients underwent a second surgery. The total number of patients who had tumor recurrence was 34 (28.3%). Only the malar location significantly influenced the incidence of recurrence (p = 0.02). The mean follow-up time was 29.54 months, with no significant difference between the follow-ups, although 32.9% of the patients followed-up clinically showed recurrence, against only 20% of those who underwent a second surgery. Study limitations Mean follow-up time of less than five years and sample size. Conclusions The presence of compromised margins does not necessarily imply recurrence. Location, tumor size, histological subtype, previous epithelial tumors, and clinical conditions of the patient must be considered when choosing the best treatment option.
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Affiliation(s)
- Maria Carolina Fidelis
- Department of Dermatology, Hospital das Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
| | - Rafael Fantelli Stelini
- Department of Pathological Anatomy, Hospital das Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Leonardo Piropo Staffa
- Ophthalmology Service, Hospital das Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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18
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[Surgical techniques in the treatment of basal cell carcinoma-a prospective investigation]. Hautarzt 2020; 71:960-968. [PMID: 32930855 PMCID: PMC7686215 DOI: 10.1007/s00105-020-04685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Hintergrund Basalzellkarzinome sind die häufigsten epithelialen Hauttumoren und eine häufige Indikation für dermatologische Eingriffe. Trotz der Etablierung medikamentöser Therapieoptionen stellt die Operation weiterhin die Therapie der Wahl dar. Hierbei stehen verschiedene Möglichkeiten zur Verfügung, die von der Kürettage bis hin zu komplexen dermatochirurgischen Eingriffen reichen. Neben dem Hauptaspekt der geringen lokalen Rezidivraten sind auch ästhetische Faktoren und die Anzahl der Eingriffe für die Wahl der Therapie wichtig. Methoden In dieser Studie wurden 347 Patienten mit 398 Basalzellkarzinomen (nodulärer Typ, Durchmesser bis 10 mm) prospektiv untersucht. Die Patienten wurden randomisiert in 2 Behandlungsarme eingeteilt: In einer Gruppe wurden die Tumoren kürettiert, in der anderen Gruppe exzidiert. Als Kontrolle dienten Patienten, die im gleichen Untersuchungszeitraum 3‑D-histologisch kontrolliert operiert wurden. Ergebnisse Die höchste lokale Rezidivrate wurde nach der Kürettage (14,0 %) beobachtet, während die Gruppe mit 3‑D-Histologie die niedrigste Rezidivrate (0,9 %; p < 0,001) aufwies. In der 3‑D-Gruppe waren mehr Re-Exzisionen erforderlich, um eine vollständige Entfernung des Tumors zu erreichen, als in der Gruppe mit histologischen Serienschnitten. Die Patienten bewerteten das ästhetische Ergebnis am besten nach der Kürettage. Die mittlere Nachbeobachtungszeit betrug 3,9 Jahre. Schlussfolgerung Die Wahl der chirurgischen Therapie bei kleinen nodulären Basalzellkarzinomen hängt von den individuellen Gegebenheiten ab. 3‑D-histologisch kontrollierte Exzisionen mit Wundverschluss nach vollständiger Tumorentfernung zeigten in unserer Studie die geringste Rezidivrate. Aber auch die Kürettage stellt eine mögliche chirurgische Therapieoption mit minimalem Aufwand und einer akzeptablen Rezidivrate dar, die zu guten ästhetischen Ergebnissen führen kann.
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19
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[Surgical resection with ophthalmoplastic reconstruction : Gold standard in periocular basal cell carcinoma]. Ophthalmologe 2020; 117:95-105. [PMID: 31562561 DOI: 10.1007/s00347-019-00973-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The gold standard for the treatment of periocular basal cell carcinoma is surgical resection followed by ophthalmoplastic reconstruction. The highest priority in most cases is the complete histopathologically controlled tumor excision. The histopathological preparation can be carried out in two stages by rapid overnight embedding or intraoperatively by a rapid frozen section procedure. A variety of reconstruction methods enable a customized and in most cases also a cosmetically and functionally attractive defect coverage. Postoperatively, a regularly performed tumor aftercare is essential.
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20
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[Periocular basal cell carcinoma]. Ophthalmologe 2020; 117:93-94. [PMID: 32034522 DOI: 10.1007/s00347-019-01026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Rokohl AC, Löser H, Mor JM, Loreck N, Koch KR, Heindl LM. [Young male patient with unusual space-occupying lesion of the lower eyelid]. Ophthalmologe 2020; 117:73-77. [PMID: 31359135 DOI: 10.1007/s00347-019-00948-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND A space-occupying lesion of the eyelid in young adults is often a sign of an inflammation, a trauma or a benign neoplasm. The aim of this case report is to demonstrate a rare basal cell carcinoma, which presumably already arose in adolescence without further high-risk factors. METHODS A 28-year-old male patient presented for a second opinion on a painless swelling of the right lower eyelid. According to the patient's history the swelling had been present since the age of 16 years and originally resembled a molluscum contagiosum. An ophthalmologist in private practice made the diagnosis of a suspected trichoepithelioma. The extended patient history revealed a blood coagulation disorder. The clinical ophthalmological examination revealed a nodular space-occupying lesion with a border wall and telangiectasia. The further ophthalmological examination was bilaterally inconspicuous. Due to the suspicion of a malignant process, an operation was promptly carried out using local anesthesia with complete tumor excision and pedicled flap plasty as well as a histopathological investigation to confirm the diagnosis. RESULTS The histopathological investigation revealed underlying infiltrates of a basaloid tumor with bale-shaped trabecular growth, sometimes with peripheral palisading of the cells. The cells were predominantly monomorphic with isolated pleomorphic nuclei and sometimes enclosed mitoses. Immunohistochemically the cells were strongly positive for BerEP4 and negative for epithelial membrane antigen (EMA). The diagnosis of a nodular basal cell carcinoma of the right lower eyelid was made. All incision margins were free of tumor cells (R0 resection). In the dermatological screening no further manifestations were detected. CONCLUSION Despite the occurrence of a space-occupying lesion of the eyelid in a young adult patient and also with no further risk factors, in addition to an inflammatory event and a benign tumor, a malignant disease, such as a basal cell carcinoma should also be taken into consideration. A tissue biopsy or complete excision with subsequent histological examination including an immunohistochemical analysis are essential for differentiation from other tumor entities.
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Affiliation(s)
- Alexander C Rokohl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
| | - Heike Löser
- Institut für Pathologie, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland
| | - Joel M Mor
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Niklas Loreck
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Konrad R Koch
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
| | - Ludwig M Heindl
- Zentrum für Augenheilkunde, Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland
- Centrum für Integrierte Onkologie (CIO) Aachen - Köln - Bonn - Düsseldorf, Köln, Deutschland
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Ferrara F, Lacava R, Barisani A, Messori S, Patrizi A, Bardazzi F, Vaccari S. Kombinierte CO
2
‐Laser‐ und photodynamische Therapie erhöht die Wirksamkeit der Behandlung von Basalzellkarzinomen. J Dtsch Dermatol Ges 2019; 17:1251-1256. [DOI: 10.1111/ddg.14004_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Francesca Ferrara
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Rossella Lacava
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Alessia Barisani
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Stefano Messori
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Annalisa Patrizi
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Federico Bardazzi
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Sabina Vaccari
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
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23
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Ferrara F, Lacava R, Barisani A, Messori S, Patrizi A, Bardazzi F, Vaccari S. Combined CO 2 laser and photodynamic therapy enhances the efficacy of treatment of basal cell carcinomas. J Dtsch Dermatol Ges 2019; 17:1251-1256. [PMID: 31814292 DOI: 10.1111/ddg.14004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/25/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES In selected cases, conventional photodynamic therapy (C-PDT) is a valid alternative to surgery for the treatment of basal cell carcinoma (BCC). However, it is limited to superficial BCCs. Pretreatment of BCCs with ablative lasers may enhance its efficacy. We evaluated the C-PDT and CO2 laser combination therapy for the treatment of superficial and nodular BCCs. PATIENTS AND METHODS In this prospective, interventional, monocentric study, patients affected by BCC were treated with CO2 laser therapy, using a continuous superpulsed CO2 laser for nodular BCCs and a fractional CO2 laser for superficial BCCs. All patients were subsequently treated with photodynamic therapy using methyl aminolevulinate cream and an Aktilite CL128® (Galderma) lamp. RESULTS 32 patients (20 males, 12 females) aged from 45 to 96 years (with a total of 181 BCCs) were treated using a CO2 laser combined with C-PDT. A 100 % cure rate was achieved at three months, with no signs of relapse in 97.2 % of the cases during the mean follow-up period (10.7 months, range 4 to 18 months). We observed mild adverse reactions and good aesthetic results. CONCLUSIONS We recommend this combination therapy in selected cases, based on its high efficacy, good aesthetic results and few side effects.
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Affiliation(s)
- Francesca Ferrara
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Rossella Lacava
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alessia Barisani
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Messori
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Federico Bardazzi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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