British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021*

Nasr, I.; McGrath, Emily; Harwood, Catherine A.; Botting, Jonathan; Buckley, Patrick J.; Budny, P.G.; Fairbrother, Patricia; Fife, Kate; Gupta, Girish; Hashme, M; Hoey, Susannah; Lear, John T.; Mallipeddi, R.; Mallon, E.; Motley, Richard; Newlands, Carrie; Newman, Jeffrey D.; Pynn, Michael; Shroff, Nick; Slater, David; Exton, L.S.; Mustapa, M.F. Mohd; Ezejimofor, Martinsixtus C.

doi:10.1111/bjd.20524

Cited by 69 publications

(87 citation statements)

References 128 publications

(320 reference statements)

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“…7 In SA, a local excision is performed chiefly with 4 mm-5mm clinical margins. 8,9 Vertical "bread-loaf" sections are then cut from the excised tissue specimen, usually at 2 to 3mm intervals and cut into 4-to 6-micrometer sections. The paraffinembedded sections are interpreted by a dermatopathologist, typically 1 to 7 days later.…”

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confidence: 99%

Complete Margin Assessment Versus Sectional Assessment in Surgically Excised High-Risk Keratinocyte Carcinomas: A Systematic Review and Meta-Analysis

et al. 2022

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BACKGROUND Keratinocyte carcinomas (KCs) are the most diagnosed cancers worldwide and are commonly excised via complete margin assessment (CMA) or excision with sectional assessment (SA). National Comprehensive Cancer Network guidelines encourage CMA for KC with high-risk features. OBJECTIVE To systematically compare recurrence outcomes for CMA vs SA in high-risk KC based on National Comprehensive Cancer Network guidelines criteria. MATERIALS AND METHODS EMBASE and MEDLINE were searched for articles reporting recurrences of high-risk KC undergoing excision using CMA or SA. High-risk KCs were defined as recurrent, having perineural invasion (PNI), or basal cell carcinomas (BCC) with aggressive histology. Chi-squared tests and risk ratios evaluated differences between CMA and SA groups, and a random-effects meta-analysis was performed. RESULTS Twenty-eight studies met inclusion criteria. Pooled percentages of locoregional recurrences were significantly lower with CMA vs SA for all KCs (3.9% [95% CI: 2.9–4.9] vs 13.5% [7.7, 19.2, p = .001]), cutaneous squamous cell carcinoma with PNI (9.8% [5.4–14.1] vs 32.0% [25.0–39.0], p < .001), and recurrent BCC (4.4% [2.9–5.9] vs 11.9% [8.0–15.8], p < .001). CONCLUSION For high-risk KCs, recurrence risk was over 3-times greater with SA compared with CMA. Expanded access to CMA for high-risk KC is likely to reduce recurrence risk and improve clinical outcomes.

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confidence: 99%

Complete Margin Assessment Versus Sectional Assessment in Surgically Excised High-Risk Keratinocyte Carcinomas: A Systematic Review and Meta-Analysis

et al. 2022

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“…[14] Modifications in the types of curette and number of cycles of treatment have been attempted, but there are no clear published guidelines for this technique. [2] A literature review has shown an overall 5-year cure rate of 92.3% after C&E for selected primary BCC and 60% for recurrent BCC. [15,16] C&E is less successful for BCC on areas with terminal hair such as beard region due to possible follicular continuation of the tumor.…”

Section: Curettage and Electrodessication (Cande)mentioning

confidence: 99%

“…Cryosurgery or cryotherapy employs liquid nitrogen to remove BCC tissue by generating a tissue temperature of at least -50 to -60° C. [2] Repeated freeze-thaw cycles and inclusion of 3-5 mm margin are recommended. [17] A French study that evaluated 395 BCCs reported a recurrence rate of 9% in 5 years which was consistent with previous reports.…”

Section: Cryosurgerymentioning

confidence: 99%

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Treatment of basal cell carcinoma: An overview

Bali

Deif

Rajeev

2022

JSSTD

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Basal cell carcinoma (BCC) is the most common cutaneous cancer worldwide, but accounts for only 2–4% of skin cancers in Asian population. Tumor characteristics such as size, location, pathology, and risk of recurrence, as well as treatment tolerability, cost, and patient preference influence the selection of treatment. The goal of treatment is complete tumor removal in superficial/locally invasive BCCs and prolongation of survival in the rare setting of metastatic BCC. Various treatment options available include conventional surgical excision, Mohs micrographic surgery, cryosurgery, electrodesiccation and curettage, topical application of imiquimod or 5-fluorouracil, and photodynamic, and radiotherapy. Surgical excision and Mohs surgery are preferred because of low recurrence rate and the possibility to evaluate the clearance through histology. In the treatment of metastatic or locally advanced lesions, hedgehog pathway inhibitors and the recently approved drug cemiplimab can be beneficial. Sun protection and regular skin self-checks are recommended for all patients with BCC. This literature review gives an overview of the treatment of BCC.

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“…In the current issue of the BJD, Nasr et al 3 have undertaken this Herculean task for the benefit of patients with BCC and clinicians treating it on a regular basis. The current guidelines set out the management of BCC in a logical sequence.…”

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confidence: 99%

Commentary on the British Association of Dermatologists UK basal cell carcinoma guidelines 2021: all together now …

Moncrieff

Nobes

2021

Br J Dermatol

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British Association of Dermatologists guidelines for the management of adults with basal cell carcinoma 2021*

Abstract: This set of guidelines has been developed using the BAD's recommended methodology 1 (Appendix J; see Supporting Information) with reference to the AGREE II instrument 2 and GRADE. 3 Recommendations were developed for implementation in the UK National Health Service (NHS).

Cited by 69 publications

References 128 publications

Complete Margin Assessment Versus Sectional Assessment in Surgically Excised High-Risk Keratinocyte Carcinomas: A Systematic Review and Meta-Analysis

Complete Margin Assessment Versus Sectional Assessment in Surgically Excised High-Risk Keratinocyte Carcinomas: A Systematic Review and Meta-Analysis

Treatment of basal cell carcinoma: An overview

Commentary on the British Association of Dermatologists UK basal cell carcinoma guidelines 2021: all together now …

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