Non-melanoma Skin Cancer in Canada Chapter 4: Management of Basal Cell Carcinoma

Zloty, David; Guenther, Lyn; Sapijaszko, Mariusz; Barber, Kirk; Claveau, Joël; Adamek, Tamara; Cancer, John Ashkenas

doi:10.1177/1203475415586664

Cited by 22 publications

(42 citation statements)

References 93 publications

(125 reference statements)

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“…Permanent hypo‐pigmentations after imiquimod treatment have been reported as an adverse event . Our network meta‐analysis could not distinguish the doses or frequency of imiquimod regimen, but some reports showed that the frequent use of high doses could work better with potentially more severe adverse events such as pruritus and pain . Although a RCT described the similar efficacy and cosmetic outcomes of FU to those of imiquimod, imiquimod showed the lower recurrence rate than FU in our study .…”

Section: Discussioncontrasting

confidence: 61%

“…Although a RCT described the similar efficacy and cosmetic outcomes of FU to those of imiquimod, imiquimod showed the lower recurrence rate than FU in our study . Cryotherapy uses liquid nitrogen to destroy tumour through freezing and is reported to be effective especially for some BCC . However, our network meta‐analysis focusing on treatment failure showed approximately 20 times higher odds compared with surgery.…”

Section: Discussionmentioning

confidence: 46%

“…However, our network meta‐analysis focusing on treatment failure showed approximately 20 times higher odds compared with surgery. Also, cryotherapy needs extensive training/experience with technique . PDT uses light that irradiates tumours with photosensitizing agents, leading to tumour cell death .…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4,[14][15][16][17] Current guidelines list many treatment options such as invasive excision, surgery or Mohs micrographic surgery (MMS), electrodessication and curettage (ED&C), cryotherapy, photodynamic therapy (PDT), radiotherapy, electrochemotherapy (ECT) and topical therapies. [1][2][3]13,15,18,19 Even after development of superficial therapies such as cryotherapy, PDT, radiotherapy, ECT or topical therapies, invasive treatments such as surgery and MMS remain the standard. 3 Some head-to-head pairwise meta-analyses were published even though such analyses can compare only two treatment options.…”

Section: Introductionmentioning

confidence: 99%

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Comparing treatments for basal cell carcinoma in terms of long‐term treatment‐failure: a network meta‐analysis

Fukumoto

Oka

et al. 2019

Acad Dermatol Venereol

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Abstracts Although many variations of guidelines have been released, there is limited research that compares multiple treatment strategies for basal cell carcinoma (BCC). The aim of this study was to systematically review the studies reporting on multiple treatments for BCC with systematic review and network meta‐analyses. Search formulas for databases, such as PubMed, EMBASE, Web of Science Core Collection and Cochrane Central Register of Controlled Trials, were created with the support of Cochrane Japan. The patient‐level and tumour‐level meta‐analyses were performed for both the long‐term treatment‐failure and treatment‐success. Of the 1464 studies identified from the database and hand searches, 14 met our inclusion criteria. These 14 studies included 2524 patients and 1738 tumours. Our study indicated that the incidence of treatment‐failure of invasive treatments such as surgery and Mohs micrographic surgery was significantly lower than that of superficial therapies such as cryotherapy, photodynamic therapy, radiotherapy or topical therapies, in the patient‐level and the tumour‐level analyses, despite histological‐type and pretreatment. Relapse of BCC may be a low life‐threatening risk, and there are merits of non‐surgical treatment. However, the significant difference in the recurrence rate is essential. Our study can provide useful guidance to clinicians in selecting treatment options for BCC.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparing treatments for basal cell carcinoma in terms of long‐term treatment‐failure: a network meta‐analysis

Fukumoto

Oka

et al. 2019

Acad Dermatol Venereol

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“…These searches were independent from the searches used to research the treatment chapters in these guidelines (Chapters 3, 4, and 5). [101][102][103] Reference lists from recent review articles were examined to identify additional studies. Clinical trials with the highest level of evidence were included.…”

Section: Methodsmentioning

confidence: 99%

Non-melanoma Skin Cancer in Canada Chapter 2: Primary Prevention of Non-melanoma Skin Cancer

Barber

Searles

Vender³

et al. 2015

J Cutan Med Surg

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Background: Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma (BCC and SCC), represents the most common malignancy. Objective: To provide guidance to Canadian health care practitioners regarding primary prevention of NMSC. Methods: Structured literature searches were conducted, using search terms including prevention, sunscreen, and sun prevention factor. All recommendations concern guidance that physicians should regularly discuss with their patients to help establish photoprotection habits. The GRADE system was used to assign strength to each recommendation. Results: Ultraviolet exposure is the major modifiable risk factor for NMSC. Aspects of photoprotection, including effective sunscreen use and avoidance of both the midday sun and artificial tanning, are discussed. Several widespread misunderstandings that undermine responsible public health measures related to sun safety are addressed. Conclusions: Photoprotection represents both an individual priority and a public health imperative. By providing accurate information during routine patient visits, physicians reinforce the need for ongoing skin cancer prevention. RésuméContexte : De tous les cancers, le carcinome cutané (non-mélanome), y compris le carcinome basocellulaire et le carcinome spinocellulaire, est le plus fréquent. Objectif : Fournir des conseils aux professionnels canadiens de la santé au sujet de la prévention du carcinome cutané. Méthodologie : On a effectué des recherches documentaires structurées à l'aide de divers mots clés, dont « prévention », « écran solaire » et « facteur de protection solaire ». Toutes les recommandations que nous avons repérées portent sur des conseils dont les médecins devraient régulièrement discuter avec leurs patients pour les aider à adopter des habitudes de photoprotection. On a utilisé l'échelle GRADE pour évaluer la pertinence de chacune des recommandations. Résultats : L'exposition aux rayons UV est le plus important facteur de risque modifiable du carcinome cutané. Certains aspects de la photoprotection, entre autres l'utilisation efficace d'un écran solaire, l'évitement du soleil de mi-journée et l'évitement du bronzage artificiel, sont examinés. Plusieurs croyances erronées répandues nuisent aux mesures de santé publique en matière de protection contre le soleil. Conclusions : La photoprotection constitue autant une priorité personnelle qu'un impératif de santé publique. En fournissant des renseignements précis aux patients lors des visites de routine, les médecins insistent sur la nécessité d'une prévention continue du cancer de la peau.

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Follow-up of Patients With Keratinocyte Carcinoma

et al. 2023

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ImportancePatients treated for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), collectively called keratinocyte carcinoma (KC), are at risk for recurrence, metastasis, and additional primary cutaneous malignant neoplasms. It is unclear how often patients should be seen for follow-up skin examination after initial treatment of KC.ObjectiveTo summarize the recommendations and evaluate the methodological quality of clinical practice guidelines for dermatologic follow-up of patients with BCC and invasive SCC.Evidence ReviewPubMed, MEDLINE, and Embase were searched for relevant articles published from January 2010 to March 2022. Search terms included guideline, squamous cell carcinoma, and basal cell carcinoma. National or international guidelines containing recommendations for follow-up frequency after a diagnosis of localized cutaneous KC were included. Quality was assessed using the 6 domains of the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool: (1) scope and purpose; (2) stakeholder development; (3) rigor of development; (4) clarity of presentation; (5) applicability; and (6) editorial independence. The Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) was used to guide study reporting.FindingsAmong the 14 guidelines meeting eligibility criteria, there was little consensus on the appropriate follow-up frequency after initial KC treatment. Overall duration of follow-up ranged from a single posttreatment visit to lifelong surveillance. Most guidelines stratified their recommendations by recurrence risk. For low-risk BCC and guidelines that did not stratify by risk, follow-up recommendations ranged from every 6 to 12 months. For high-risk BCC, 1 guideline suggested follow-up every 3 months, while 4 recommended every 6 months. For low-risk SCC, 5 guidelines recommended annual follow-up; 3 guidelines, every 6 months; and 1 guideline, every 3 months. For high-risk SCC, recommendations included a range of follow-up frequencies, spanning every 3 months (n = 5 guidelines), 4 months (n = 1), 6 months (n = 6), or annually (n = 4). One guideline did not use risk stratification and recommended annual screening. The highest scoring AGREE II domain was “scope and purpose,” which assessed the guideline’s overall objectives, and the lowest scoring was “applicability,” which assessed barriers and facilitators to implementation.Conclusions and RelevanceThe findings of this systemic review highlight variations in follow-up recommendations for patients after initial treatment for KC. Randomized clinical trials are needed to define an optimal follow-up regimen.

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Non-melanoma Skin Cancer in Canada Chapter 4: Management of Basal Cell Carcinoma

Cited by 22 publications

References 93 publications

Comparing treatments for basal cell carcinoma in terms of long‐term treatment‐failure: a network meta‐analysis

Comparing treatments for basal cell carcinoma in terms of long‐term treatment‐failure: a network meta‐analysis

Non-melanoma Skin Cancer in Canada Chapter 2: Primary Prevention of Non-melanoma Skin Cancer

Follow-up of Patients With Keratinocyte Carcinoma

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