Thickness of superficial basal cell carcinoma (sBCC) predicts imiquimod efficacy: a proposal for a thickness-based definition of sBCC

McKay, Kristopher; Sambrano, Brittany L.; Fox, Patricia S.; Bassett, Roland L.; Chon, Susan Y.; Prieto, Víctor G.

doi:10.1111/bjd.12402

Cited by 55 publications

(41 citation statements)

References 33 publications

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“…We found no evidence that these histologic parameters have to be taken into 13 also recommended that adnexal extension should be measured in pathology reports, but no statistical analyses were reported to support this finding. Based on our analyses we found no evidence that adnexal extension is a determinant of noninvasive treatment failure in sBCC.…”

Section: Discussionmentioning

confidence: 58%

“…The maximum tumor thickness of sBCC in the current study was 1.0 mm and therefore the data do not allow conclusions about tumors thicker than 1.0 mm. However, previous findings of McKay et al 13 indicate that thickness of the majority of sBCC does not exceed 1.0 mm.…”

Section: Discussionmentioning

confidence: 75%

“…Only 1 study focused solely on sBCC and showed that after treatment with imiquimod a tumor with a thickness more than 0.4 mm was significantly more likely to reoccur than a thinner tumor. 13 The objective of this study was to investigate whether increased tumor thickness and adnexal extension are determinants of treatment failure in sBCC treated with methylaminolevulinate (MAL) PDT, imiquimod, or 5-FU.…”

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confidence: 99%

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Tumor thickness and adnexal extension of superficial basal cell carcinoma (sBCC) as determinants of treatment failure for methylaminolevulinate (MAL)-photodynamic therapy (PDT), imiquimod, and 5-fluorouracil (FU)

Roozeboom

Kleef

Arits

et al. 2015

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 75%

mentioning

confidence: 99%

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Tumor thickness and adnexal extension of superficial basal cell carcinoma (sBCC) as determinants of treatment failure for methylaminolevulinate (MAL)-photodynamic therapy (PDT), imiquimod, and 5-fluorouracil (FU)

Roozeboom

Kleef

Arits

et al. 2015

Journal of the American Academy of Dermatology

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“…This distinction is important, as classification of BCC as superficial indicates the patient is a candidate for topical therapy. McKay and co‐workers found BCC thickness of ≤0.4 mm was associated with lack of recurrence after topical imiquimod therapy . One of this study's authors (GRF) found it helpful to apply this threshold in practice using known objective field diameters.…”

Section: Discussionmentioning

confidence: 90%

Diagnostic concordance rates in the subtyping of basal cell carcinoma by different dermatopathologists

Nedved

Tonkovic-Capin

Hunt³

et al. 2013

J Cutan Pathol

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Journal of Cutaneous PathologyDiagnostic concordance rates in the subtyping of basal cell carcinoma by different dermatopathologists Background There are numerous subtypes of basal cell carcinoma (BCC). Defining the histopathologic subtype is an essential element in patient management, but there is little known data regarding interobserver precision in subtyping BCC. Methods We studied interobserver variance between six board-certified dermatopathologists who subtyped 100 BCCs in a blinded fashion. We used kappa statistic to calculate the concordance in suggested subtype by different dermatopathologists. Provided diagnoses were then re-categorized into low-risk and high-risk phenotypes, and kappa statistic for concordance on high-risk BCC was determined. Results The overall κ statistic was 0.301, indicating fair agreement among the six observers. Superficial and fibroepithelial BCC had the highest individual kappa statistics. When subtypes were re-classified into a two-tier system of high-risk and low-risk phenotypes, there was substantial interobserver agreement on high-risk BCC with a κ statistic of 0.699. Conclusion These results suggest only fair agreement among dermatopathologists on specific BCC subtypes, but substantial agreement on superficial, fibroepithelial and high-risk BCC growth patterns. A simplified classification system comprised of superficial, fibroepithelial, nodular and infiltrative subtypes would increase interobserver precision and facilitate clinical decision-making.

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“…The nodular BCC (nBCC) is the most common histopathological subtype, but an increase in the proportion of superficial BCC (sBCC) and infiltrating BCC (iBCC) has been reported . Within recent years, several non‐surgical treatments have been established for treatment of BCC . The histopathological subtype of BCC is, however, correlated with treatment outcome and recommended treatment options therefore differ.…”

Section: Introductionmentioning

confidence: 99%

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

Themstrup

Carvalho

Nielsen

et al. 2018

Experimental Dermatology

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The subtype of basal cell carcinoma (BCC) influences the choice of treatment. Optical coherence tomography (OCT) is a non-invasive imaging tool, and a recent development of an angiographic version of OCT has extended the application of OCT to image the cutaneous microvasculature (so-called dynamic OCT, D-OCT). This study explores D-OCT's ability to differentiate the common BCC subtypes by microvascular and structural imaging. Eighty-one patients with 98 BCC lesions, consisting of three subtypes: 27 superficial BCC (sBCC), 55 nodular BCC (nBCC) and 16 infiltrative BCC (iBCC) were D-OCT scanned at three European dermatology centres. Blinded evaluations of microvascular and structural features were performed, followed by extensive statistical analysis of risk ratio (RR) and multiple correspondence analysis. nBCC lesions displayed most characteristic structural and vascular features. Serpiginous vessels, branching vessels, vessels creating a circumscribed figure and sharply demarcated hyporeflective ovoid structures in the dermis were all associated with a higher risk of the subtype being nBCC. The presence of highly present lines and dark peripheral borders at the margin of ovoid structures was negatively associated with iBCC. Lastly, the finding of hyporeflective ovoid structures protruding from epidermis correlated with sBCC. We identified various microvascular and structural D-OCT features that may aid non-invasive identification of BCC subtypes. This would allow clinicians to individualize and optimize BCC treatment as well as aid follow-up of non-surgical treatment.

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Thickness of superficial basal cell carcinoma (sBCC) predicts imiquimod efficacy: a proposal for a thickness-based definition of sBCC

Abstract: We recommend the use of tumour thickness to define the superficial pattern in pathology reports for BCC as this can help to determine treatment response of sBCC to imiquimod.

Cited by 55 publications

References 33 publications

Tumor thickness and adnexal extension of superficial basal cell carcinoma (sBCC) as determinants of treatment failure for methylaminolevulinate (MAL)-photodynamic therapy (PDT), imiquimod, and 5-fluorouracil (FU)

Tumor thickness and adnexal extension of superficial basal cell carcinoma (sBCC) as determinants of treatment failure for methylaminolevulinate (MAL)-photodynamic therapy (PDT), imiquimod, and 5-fluorouracil (FU)

Diagnostic concordance rates in the subtyping of basal cell carcinoma by different dermatopathologists

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

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