Reflectance confocal microscopy-guided carbon dioxide laser ablation of low-risk basal cell carcinomas: A prospective study - 12/09/19
Abstract |
Background |
Basal cell carcinoma (BCC) treatment modalities can be stratified by tumor subtype and recurrence risk. The main limitation of nonsurgical treatment modalities is the lack of histopathologic confirmation. Reflectance confocal microscopy (RCM) is a noninvasive imaging device that provides quasihistologic images.
Objective |
To evaluate the feasibility and efficacy of RCM-guided carbon dioxide (CO2) laser ablation of low-risk BCCs.
Methods |
Prospective study with biopsy specimen–proven low-risk BCCs imaged with RCM. RCM was performed on these sites before and after ablation. If residual tumor was found, a new series of laser passes were performed. The patients were then monitored for recurrence clinically and with RCM.
Results |
Twenty-two tumor sites in 9 patients (5 men, 4 women) were imaged and treated. Median age was 59 ± 12.9 years (range, 30-74 years). Mean tumor size was 7.7 mm (range, 5-10 mm). Residual tumor was identified in 5 of 22 cases (22.7%) under RCM on immediate first-pass postablation sites, prompting additional laser passes. Median follow-up was 28.5 months (range, 22-32 months) with no recurrences found.
Conclusions |
Addition of RCM to laser ablation workflow can detect subclinical persistent tumor after initial ablation and may serve as an aid to increase the efficacy of laser ablation.
Le texte complet de cet article est disponible en PDF.Key words : ablation, basal cell carcinoma, carbon dioxide laser, diagnosis, follow-up, laser, reflectance confocal microscopy, treatment
Plan
| Funding sources: This research was partly funded by a grant from the National Cancer Institute of the National Institutes of Health (P30-CA008748) to the Memorial Sloan Kettering Cancer Center. Parts of this research were also funded by grants from the Skin Cancer Foundation and the A. Ward Ford Memorial Grant to Dr Rossi. |
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| Conflicts of interest: Dr Rajadhyaksha is a former employee of and owns equity in Caliber I.D. (formerly, Lucid Inc), the company that manufactures and sells a reflectance confocal microscope (VivaScope). The VivaScope, for reflectance confocal microscopy imaging, is the commercial version of an original laboratory prototype that was developed by Dr Rajadhyaksha when he was at Massachusetts General Hospital, Harvard Medical School. Dr Rossi has no relevant conflicts of interest related to this manuscript. Dr Rossi has served on advisory board, as a consultant, or has given educational presentations for Allergan Inc, Galderma Inc, Evolus Inc, Elekta, Biofrontera, Quantia, Merz Inc, Dynamed, Skinuvia, Perf-Action, and LAM therapeutics. Drs Navarrete-Dechent, Cordova, Liopyris, Yélamos, Aleissa, Hibler, Sierra, Sahu, and Blank have no conflicts of interest to declare. |
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| Reprints not available from the authors. |
Vol 81 - N° 4
P. 984-988 - octobre 2019 Retour au numéro
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