Review: Treatments for primary basal cell carcinoma compared

(HealthDay)—For patients with primary basal cell carcinoma (BCC), estimated recurrence rates are similarly low for excision, Mohs surgery, curettage and diathermy, and external-beam radiation, according to a review and meta-analysis published online Sept. 18 in the Annals of Internal Medicine.

Aaron M. Drucker, M.D., from the Alpert Medical School of Brown University in Providence, R.I., and colleagues conducted a systematic review to examine the comparative effectiveness and safety of primary BCC treatments in adults. Eighteen interventions in nine categories were compared in 40 randomized trials and five non-randomized studies.

The researchers found that the estimated recurrence rates were similar for excision, Mohs surgery, curettage and diathermy, and external-beam radiation (3.8, 3.8, 6.9, and 3.5 percent, respectively). For cryotherapy, curettage and cryotherapy, 5-fluorouracil, imiquimod, and photodynamic therapy using methyl-aminolevulinic acid or aminolevulinic acid, the recurrence rates were higher (22.3, 19.9, 18.8, 14.1, 18.8, and 16.6 percent, respectively). Compared with excision or cryotherapy, for phototherapy using methyl-aminolevulinic acid or aminolevulinic acid there was a higher proportion of patients reporting good or better cosmetic outcomes (93.8 and 95.8, respectively, versus 77.8 and 51.1 percent, respectively).

"Surgical treatments and external-beam radiation have low recurrence rates for the treatment of low-risk BCC, but substantial uncertainty exists about their comparative effectiveness versus other treatments," the authors write. "Gaps remain regarding high-risk BCC subtypes and important outcomes, including costs."

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