European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma—update 2023

Peris, Ketty; Fargnoli, Maria Concetta; Kaufmann, Roland; Arenberger, Petr; Bastholt, Lars; Seguin, Nicole Basset; Bataille, Veronique; Brochez, Lieve; del Marmol, Veronique; Dummer, Reinhard; Forsea, Ana-Marie; Gaudy-Marqueste, Caroline; Harwood, Catherine A.; Hauschild, Axel; Höller, Christoph; Kandolf, Lidija; Kellerners-Smeets, Nicole W.J.; Lallas, Aimilios; Leiter, Ulrike; Malvehy, Josep; Marinović, Branka; Mijuskovic, Zeljko; Moreno-Ramirez, David; Nagore, Eduardo; Nathan, Paul; Stratigos, Alexander J.; Stockfleth, Eggert; Tagliaferri, Luca; Trakatelli, Myrto; Vieira, Ricardo; Zalaudek, Iris; Garbe, Claus

doi:10.1016/j.ejca.2023.113254

Cited by 65 publications

(47 citation statements)

References 213 publications

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“…[ 21 ] For high-risk or recurrent BCC, MMS is the optimal surgical choice, boasting cure rates between 94% to 99%. [ 3 ] Citation bursts for MMS, ranking fifth in frequency, first emerged in 2013. [ 11 ] MMS offers the benefits of minimized incomplete resections and reduced recurrence rates.…”

Section: Discussionmentioning

confidence: 99%

“…BCC incidence is generally higher in men than in women, barring the under-40 female demographic, and typically reaches its zenith around 80 years of age, manifesting as asymptomatic, enlarging, and often hemorrhagic lesions. [ 1 – 3 ] Factors predisposing individuals to BCC encompass UV light exposure, fair skin tone, chronic immunosuppression, male gender, advanced age, and certain genetic skin disorders, culminating in the highest occurrence in Caucasians, with a projected 30% lifetime BCC risk for Caucasian North Americans. [ 4 ] Notably, BCC incidence has surged by 5% annually over the previous decade, with Australia reporting the peak incidence rates.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The top 100 most cited articles in the treatment of basal cell carcinoma over the last decade: A bibliometric analysis and review

Lin,

Luo,

Zhuo

et al. 2024

Medicine

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Basal cell carcinoma (BCC) represents the most prevalent cancer globally. The past decade has witnessed significant advancements in BCC treatment, primarily through bibliometric studies. Aiming to perform a comprehensive bibliometric analysis of BCC treatments to comprehend the research landscape and identify trends within this domain, a dataset comprising 100 scientific publications from the Web of Science Core Collection was analyzed. Country co-operation, journal co-citation, theme bursts, keyword co-occurrence, author co-operation, literature co-citation, and field-specific references were examined using VOSviewer and CiteSpace visualization tools. These articles, published between 2013 and 2020, originated predominantly from 30 countries/regions and 159 institutions, with the USA and Germany at the forefront, involving a total of 1118 authors. The keyword analysis revealed significant emphasis on the hedgehog pathway, Mohs micrographic surgery, and photodynamic therapy. The research shows developed nations are at the forefront in advancing BCC therapies, with significant focus on drugs targeting the hedgehog pathway. This treatment avenue has emerged as a crucial area, meriting considerable attention in BCC therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The top 100 most cited articles in the treatment of basal cell carcinoma over the last decade: A bibliometric analysis and review

Lin,

Luo,

Zhuo

et al. 2024

Medicine

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“…BCC is a slowly growing, locally invasive skin cancer that commonly affects individuals with a significant history of sun exposure or Gorlin syndrome [ 53 ]. Surgical excision is the most prevalent and effective treatment for BCC.…”

Section: Basal Cell Carcinomamentioning

confidence: 99%

“…The recently updated European Dermatology Forum (EDF) and European Association of Dermato-Oncology (EADO) guidelines propose a simplified and operational classification of BCCs into ’easy to treat’ and ’difficult to treat’ categories. Factors that make BCCs difficult to treat include technical issues in maintaining function and esthetics, ill-defined boundaries, multiple recurrences, or prior radiotherapy [ 53 ].…”

Section: Basal Cell Carcinomamentioning

confidence: 99%

Head and neck nonmelanoma skin cancers: surgical management and debated issues

Rampinelli,

Pinacoli,

Piazza

2024

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review This review critically assesses the current literature and guidelines, aiming to clarify some of the most important factors that impact surgical strategies of head and neck nonmelanoma skin cancers (NMSCs), focusing on squamous, basal, and Merkel cell carcinomas. Recent findings Recent developments underscore the complexity of treatment for NMSC, particularly in the head and neck region. There is a lack of high-level evidence for the management of these tumors, especially in advanced stages. The need to tailor the extent of surgical margins and parotid/neck management to different histotypes, considering the varying risk factors for recurrence, is beginning to emerge in the literature. Moreover, the role of immunotherapy and targeted therapies for locally advanced disease, alongsi de traditional treatment options, is progressively growing. Summary NMSCs represent a heterogeneous group of malignancies with varying treatment complexities and prognoses. Management of NMSC is evolving towards an increasingly personalized strategy within a multidisciplinary therapeutic framework.

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“…7,9 Previous studies have reported the superior efficacy of MS in reducing recurrences, particularly in the context of high-risk NMSC cases (recurrent tumours, those located in the H-zone or in areas previously exposed to radiotherapy, tumours with aggressive histological subtypes or immunocompromised patients). 10,11 However, it is important to note that existing comparative studies are hindered by various limitations, including study designs, sample selection biases, imprecise determination of recurrence and incomplete follow-up. Therefore, this systematic review aims to fill a gap in current knowledge about the treatment of NMSC and assess recurrence rates of MS and CS for BCCs and SCCs by including randomized clinical trials and controlled observational studies, such as cohorts.…”

mentioning

confidence: 99%

Efficacy of micrographic surgery versus conventional excision in reducing recurrence for basal cell carcinoma and squamous cell carcinoma: A systematic review and meta‐analysis

Lacerda,

Lange,

Luna

et al. 2023

Acad Dermatol Venereol

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The standard of care for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) involves excision by conventional surgery (CS) with a predefined safety margin of resection or micrographic surgery (MS) with microscopic margin control. Previous studies have reported the superiority of MS in reducing recurrences for high‐risk BCC and SCC. This systematic review aimed to assess MS and CS recurrence rates by including randomized clinical trials (RCTs) and cohort studies. A systematic review and meta‐analysis were conducted for related studies in PubMed, LILACS, Embase, Scopus, Web of Science, CINHAL and Cochrane until May 2023. RCTs and cohorts involving patients with BCC or SCC submitted to MS and CS were included. Risk of bias assessment followed Cochrane‐recommended tools for RCTs and cohorts, and certainty of evidence followed the GRADE approach. Pooled estimates were used to determine the relative risk (RR) and absolute risk difference (RD) using a random‐effects model. Seventeen studies were included, two RCTs and fifteen cohorts. There were 82 recurrences in 3050 tumours submitted to MS, with an overall recurrence rate of 3.1% (95% CI 2.0%–4.7%). For CS, there were 209 recurrences in 3453 tumours, with a recurrence rate of 5.3% (95% CI 2.9%–9.3%). The combined estimate of RR was 0.48 (95% CI 0.36–0.63), without heterogeneity nor evidence of publication bias (p > 0.3). The RD resulted in 2.9% (95% CI 1.0%–4.9%; NNT = 35). Regarding subgroup analysis, the RR for BBC was 0.37 (95% CI 0.25–0.54), and RD was 3.7% (95% CI 0.8%–6.5%; NNT = 28). For SCC, RR was 0.57 (95% CI 0.29–1.13), and RD was 1.9% (95% CI 0.8%–4.7%; NNT = 53). Among primary tumours, RR was 0.39 (95% CI 0.28–0.54), and for recurrent tumours was 0.67 (95% CI 0.30–1.50). There is moderate evidence based on two RCTs, and low evidence based on 15 cohort studies that MS is superior to CS in reducing recurrences of BCCs and primary tumours. The development of protocols that maximize the cost‐effectiveness of each method in different clinical scenarios is paramount.

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European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma—update 2023

Cited by 65 publications

References 213 publications

The top 100 most cited articles in the treatment of basal cell carcinoma over the last decade: A bibliometric analysis and review

The top 100 most cited articles in the treatment of basal cell carcinoma over the last decade: A bibliometric analysis and review

Head and neck nonmelanoma skin cancers: surgical management and debated issues

Efficacy of micrographic surgery versus conventional excision in reducing recurrence for basal cell carcinoma and squamous cell carcinoma: A systematic review and meta‐analysis

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