Nitrous oxide cryotherapy for primary periocular basal cell carcinoma: outcome at 5 years follow-up

Moesen, Ingemarie; Duncan, Martin; Cates, Carolyn A.; Taylor, Alexandra; Rv, Wintle; Ismail, Ahmed M.; Dk, Lim; Tyers, AG

doi:10.1136/bjo.2009.173021

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…As an easy, simple, and no time-consuming method, cryotherapy has certain advantages over surgical techniques in cases with multiple BCC tumors. The recurrence rate after treatment of small-sized (<8 mm) primary BCC is about 8%[16] however, these patients need careful follow-up. Specific contraindications are localizations in naso-labial fold, ala nasi , tragus, eyelid edge.…”

Section: Therapeutic Approaches At Treatment Of Bccmentioning

confidence: 99%

Clinical variants, stages, and management of basal cell carcinoma

Dourmishev

Rusinova²,

Botev

2013

Indian Dermatol Online J

106

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Basal cell carcinoma (BCC) is the most common paraneoplastic disease among human neoplasms. The tumor affects mainly photoexposed areas, most often in the head and seldom appears on genitalia and perigenital region. BCC progresses slowly and metastases are found in less than 0.5% of the cases; however, a considerable local destruction and mutilation could be observed when treatment is neglected or inadequate. Different variants as nodular, cystic, micronodular, superficial, pigment BCC are described in literature and the differential diagnosis in some cases could be difficult. The staging of BCC is made according to Tumor, Node, Metastasis (TNM) classification and is essential for performing the adequate treatment. Numerous therapeutic methods established for treatment of BCC, having their advantages or disadvantages, do not absolutely dissolve the risk of relapses. The early diagnostics based on the good knowledge and timely organized and adequate treatment is a precondition for better prognosis. Despite the slow progress and numerous therapeutic methods, the basal cell carcinoma should not be underestimated.

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Section: Therapeutic Approaches At Treatment Of Bccmentioning

confidence: 99%

Clinical variants, stages, and management of basal cell carcinoma

Dourmishev

Rusinova²,

Botev

2013

Indian Dermatol Online J

106

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“…It is worth noting that contact of imiquimod with the ocular surface is generally safe and the substance has been successfully applied directly on conjunctival actinic keratoses for their treatment [20]. On the other hand, in the past decades cryosurgery has been extensively employed to treat pBCC and it has even been proposed as a tissue-sparing, first-line therapy for selected, mostly smaller (<1 cm in maximal diameter) [20,21,22,23] or well-circumscribed pBCC [24]. Finally, with immunocryosurgery healing is generally excellent (fig.…”

Section: Discussionmentioning

confidence: 99%

Cryosurgery during Imiquimod (Immunocryosurgery) for Periocular Basal Cell Carcinomas: An Efficacious Minimally Invasive Treatment Alternative

Gaitanis

Kalogeropoulos²,

Bassukas³

2015

Dermatology

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Background/Aim: Periocular basal cell carcinomas (pBCC) remain a treatment challenge. Our aim was to retrospectively evaluate the feasibility and efficacy of immunocryosurgery for the treatment of pBCC. Methods: Immunocryosurgery is given in 5-week cycles of daily imiquimod, with cryosurgery on day 14. Patients treated between 1/1/2008 and 31/12/2014 were included in this study. Results: Immunocryosurgery was offered to 19 patients. Of these, 16 (i.e. 6 males and 10 females, average age 74.9 years, median tumor diameter 15 mm, range 5-60 mm), with 1 tumor each, were treated. Six tumors (37.5%) were relapses after surgery and 2 were of metatypical histology. All BCC were high risk for recurrence after treatment; 10 tumors had 2 risk factors for relapse, 5 had 3, and 1 had 4. The follow-up period ranged between 3 and 60 months (average 25.6 months). Of the 16 tumors treated, 14 (all with a diameter <40 mm) cleared with immunocryosurgery (total efficacy 87.5%); 7 out of 16 tumors (44%; all with a diameter ≤20 mm) cleared with 1 conventional 5-week immunocryosurgery treatment cycle. Seven additional tumors (including 2 with a diameter >20 mm) required intensified treatment schemes (of up to 10 weeks) for clearance. The 2 tumors that did not clear responded partially and were also the 2 largest ones (diameter 40 and 60 mm). Of the 14 cleared tumors, 2 relapsed during follow-up; 1 cleared with immunocryosurgery. At the last examination during follow-up, 13 out of 16 (81%) patients were in sustained clinical remission. Conclusions: For most pBCC, immunocryosurgery is a feasible and efficacious alternative to surgical excision.

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“…In the treatment of primary periocular BCCs, cryosurgery with nitrous oxide probe may be an alternative treatment modality in the absence of appropriate surgical procedures. The disadvantage of this procedure is higher recurrence rate, approximately 8%, compared with other treatment modalities (Moesen et al, 2010). But Emanuel and her colleagues reported that 5-years cure rate and 30-years cure rate for basal cell carcinoma after cryosurgery were 99% and 98,6% respectively (Kuflik, 2004).…”

Section: Cryosurgerymentioning

confidence: 99%

“…Cryosurgery is usually suitable for BCC lesions with well-defined borders (Ceilley Del & Rosso, 2006). Liquid nitrogen has a boiling point of -195ºC, making it a very effective cryotherapy agent (Moesen et al, 2010). Two freeze-thaw cycles (30 seconds each cycle duration) with a tissue temperature of -50 ºC are recommended (Ceilley Del & Rosso, 2006).…”

Section: Cryosurgerymentioning

confidence: 99%