Review: Treatments for Primary Basal Cell Carcinoma Compared
HealthDay News — For patients with primary basal cell carcinoma (BCC), estimated recurrence rates are similarly low for excision, Mohs surgery, curettage and diathermy, and external-beam radiation, according to a review and meta-analysis published online September 18 in the Annals of Internal Medicine.
Aaron M. Drucker, MD, from the Alpert Medical School of Brown University in Providence, RI, and colleagues conducted a systematic review to examine the comparative effectiveness and safety of primary BCC treatments in adults. Eighteen interventions in 9 categories were compared in 40 randomized trials and five non-randomized studies.
The researchers found that the estimated recurrence rates were similar for excision, Mohs surgery, curettage and diathermy, and external-beam radiation (3.8, 3.8, 6.9, and 3.5%, respectively). For cryotherapy, curettage and cryotherapy, 5-fluorouracil, imiquimod, and photodynamic therapy using methyl-aminolevulinic acid or aminolevulinic acid, the recurrence rates were higher (22.3, 19.9, 18.8, 14.1, 18.8, and 16.6%, respectively). Compared with excision or cryotherapy, for phototherapy using methyl-aminolevulinic acid or aminolevulinic acid there was a higher proportion of patients reporting good or better cosmetic outcomes (93.8 and 95.8, respectively, versus 77.8 and 51.1%, respectively).
"Surgical treatments and external-beam radiation have low recurrence rates for the treatment of low-risk BCC, but substantial uncertainty exists about their comparative effectiveness vs other treatments," the authors write. "Gaps remain regarding high-risk BCC subtypes and important outcomes, including costs."