A prospective study of the use of cryosurgery for the treatment of actinic keratoses

Thai, Keng‐Ee; Fergin, Peter; Freeman, Michael L.; Vinciullo, Carl; Francis, David M.; Spelman, Lynda; Murrell, Dédée F.; Anderson, Chris; Weightman, Warren; Reid, Catherine; Watson, A.C.H.; Foley, Peter

doi:10.1111/j.1365-4632.2004.02056.x

Cited by 148 publications

(108 citation statements)

References 16 publications

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“…40 In another study using LN 2 cryosurgery, 68% of patients were free of AKs 6 weeks after receiving 1 or 2 treatment sessions. 23 However, further lesions can be expected to develop, as cryosurgery targets only clinically evident lesions.…”

Section: Cryosurgerymentioning

confidence: 99%

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Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

et al. 2015

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Background Actinic keratosis (AK) and cheilitis (AC) are lesions that develop on photodamaged skin and may progress to form invasive squamous cell carcinomas (SCCs). Objective To provide guidance to Canadian health care practitioners regarding management of AKs and ACs. Methods Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines). Results Treatment of AKs allows for secondary prevention of skin cancer in sun-damaged skin. Because it is impossible to predict whether a given AK will regress, persist, or progress, AKs should ideally be treated. This chapter discusses options for the management of AKs and ACs. Conclusions Treatment options include surgical removal, topical treatment, and photodynamic therapy. Combined modalities may be used in case of inadequate response. AKs are particularly common following the longterm immunosuppression in organ transplant patients, who should be monitored frequently to identify emerging lesions that require surgery.

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Section: Cryosurgerymentioning

confidence: 99%

“…Cryosurgery is inexpensive, accessible, and well tolerated. Cryosurgery outcomes are operator dependent and vary depending on freeze time, 40 the number of LN 2 applications, and other parameters. Reported AK clearance rates vary substantially across studies, due in large part to the lack of standardization of this procedure.…”

Section: Cryosurgerymentioning

confidence: 99%

Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

et al. 2015

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“…A longer treatment time (10-15 s) has been proposed when performing cryosurgery for thicker or hyperkeratotic lesions. [33][34][35] Previously reported recurrence rates in a larger (n = 470) study of 0.5% 5-FU/SA were 8.4% and 14.2% at 6 and 12 months, respectively, after the end of treatment. 17,18 The AKs in this previous study were located on the face/forehead or bald scalp and were mild/moderate (grade I/II) only; 0.5% 5-FU/SA was applied for up to 12 weeks.…”

Section: Discussionmentioning

confidence: 93%

A prospective randomized exploratory study comparing the efficacy of once‐daily topical 0.5% 5‐fluorouracil in combination with 10.0% salicylic acid (5‐FU/SA) vs. cryosurgery for the treatment of hyperkeratotic actinic keratosis

Simon

Dominicus

Karl³

et al. 2014

Acad Dermatol Venereol

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A prospective randomized exploratory study comparing the efficacy of once-daily topical 0.5% 5-fluorouracil in combination with 10.0% salicylic acid (5-FU/SA) vs. cryosurgery for the treatment of hyperkeratotic actinic keratosis Mean change in lesion count from baseline to Day 98 was À5.2 and À5.7 lesions per patient for 0.5% 5-FU/SA and cryotherapy groups respectively. Histological AK clearance rates on Day 98 were 62.1% and 41.9% respectively. At 6-month posttreatment follow-up, recurrence of cleared lesions (no clinically visible lesions in treatment area) occurred in 39.4% of 0.5% 5-FU/SA and 84.8% of cryosurgery patients. Drug-related adverse events (AEs), including local skin reactions considered 'severe' by the investigator, were reported in 24.2% of 0.5% 5-FU/SA and 6.1% of cryosurgery patients. All drug-related AEs were skin reactions.Conclusions Although the study was not powered to explore statistical differences in clinical efficacy between treatments, a short (6-week) schedule of topical treatment with 0.5% 5-FU/SA achieved greater histological clearance and lower recurrence of grade II/III hyperkeratotic AKs than cryosurgery. AE incidence across both treatment groups was relatively low and AEs were generally mild or moderate. Clinical trials.gov identifier: NCT01358851.

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“…Não observamos nos nossos pacientes, efeitos colaterais descritos por alguns autores, tais como neuropatias e fotosensibilidade 9 . A literatura aponta como principais desvantagens: a dor, ardor e queimação durante o tratamento e a hipopigmentação local após descamação da crosta necrótica 10 . Outra limitação deste método são os resultados pobres com determinados tipos de lesão.…”

Section: Discussionunclassified

Papel da criocirurgia no tratamento das neoplasias cutâneas do segmento cabeça e pescoço: análise de 1900 casos

Antunes¹,

Silva²

2006

Rev. Col. Bras. Cir.

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OBJETIVO: Demonstrar a experiência dos autores na utilização da criocirurgia como tratamento de lesões benignas e malignas da pele e mucosa no segmento cabeça e pescoço. MÉTODO: Os autores realizam um estudo retrospectivo multicêntrico de 1900 casos de pacientes portadores de neoplasias benignas e malignas da cabeça e do pescoço, atendidos e tratados no Centro de Oncologia do Hospital Universitário Oswaldo Cruz (CEON/HUOC/UPE), Hospital de Câncer de Pernambuco (HCP) e clínica privada, no período de abril de 1977 a abril de 2002 (25 anos). Comparam, ainda, os dados obtidos com a revisão bibliográfica realizada, bem como sua experiência pessoal na utilização de tal modalidade terapêutica. RESULTADOS: Do total de pacientes, 57,9% eram do sexo masculino e a quinta e sexta décadas de vida foram as mais frequentemente acometidas (58,9%). O Carcinoma basocelular foi o tipo histológico predominante (63,1% - 1200 casos), seguido dos hemangiomas (14,2% - 270 casos). O tempo médio de exposição das lesões ao nitrogênio líquido foi de 15 e 35 segundos, e o tempo médio de cicatrização de 14 e 21 dias para as lesões benignas e malignas respectivamente. CONCLUSÕES: A indicação da criocirurgia deve obedecer alguns critérios de avaliação como o aspecto macroscópico e tamanho da lesão, tipo histológico, localização, idade e perfil social de cada paciente. Quando indicada e executada corretamente, oferece idênticos índices de cura aos outros métodos terapêuticos convencionais.

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A prospective study of the use of cryosurgery for the treatment of actinic keratoses

Abstract: Cryosurgery is an effective treatment for actinic keratoses. The true complete response rate is significantly lower than that previously reported. The freeze duration influences successful treatment. Adverse events are mild and well tolerated.

Cited by 148 publications

References 16 publications

Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

A prospective randomized exploratory study comparing the efficacy of once‐daily topical 0.5% 5‐fluorouracil in combination with 10.0% salicylic acid (5‐FU/SA) vs. cryosurgery for the treatment of hyperkeratotic actinic keratosis

Papel da criocirurgia no tratamento das neoplasias cutâneas do segmento cabeça e pescoço: análise de 1900 casos

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