Factors predictive of recurrence, metastasis, and death from primary basal cell carcinoma 2 cm or larger in diameter - 19/08/20
Abstract |
Background |
Basal cell carcinoma (BCC) recurrence and metastatic rates are known to be very low. The risk factors for these rare outcomes are subsequently not well studied.
Objective |
To identify risk factors independently associated with local recurrence (LR) and metastasis and/or death (M/D) in large (≥2 cm) BCC.
Methods |
BCCs histologically confirmed between 2000 and 2009 were retrospectively screened for tumor diameter at 2 academic centers. Medical records of all large BCCs and an equal number of randomly selected small BCCs were reviewed for LR and M/D.
Results |
Included were 248 large BCC and 248 small BCC tumors. Large BCCs had a significantly higher risk of LR and M/D than small BCCs (LR: 8.9% vs 0.8%, P < .001; M/D: 6.5% vs. 0%, P < .001). Because the risks were so low in small BCCs, they were excluded from further analysis. On multivariable logistic regression, head/neck location (odds ratio [OR], 9.7; 95% confidence interval [CI], 3.0-31.3) and depth beyond fat (OR, 3.1; 95% CI, 1.0-9.6) were associated with LR in large BCCs. Risk of LR was lower with Mohs micrographic surgery (OR, 0.14; 95% CI, 0.04-0.5). Head/neck location (OR, 5.3; 95% CI, 1.2-23.2), tumor diameter ≥4 cm (OR, 11.9; 95% CI, 2.4-59.4), and depth beyond fat (OR, 28.6; 95% CI, 6.7-121) were significant predictors of M/D in large BCCs.
Limitations |
Retrospective cohort design.
Conclusions |
Large BCCs, particularly those with additional risk factors, have a high enough risk of recurrence and metastasis to warrant further investigation to optimize management.
Le texte complet de cet article est disponible en PDF.Key words : basal cell carcinoma, local recurrence, LR, metastasis, MMS, Mohs micrographic surgery, outcomes, recurrence, risk factors
Abbreviations used : BCC, CI, LR, mBCC, M/D, MMS, OR
Plan
| Funding sources: Genentech, Inc provided support for the conduct of this study. Mr Karia is supported by a Cancer Epidemiology, Prevention, and Control Training Grant from the National Cancer Institute of the National Institutes of Health (T32-CA-009314). |
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| Conflicts of interest: None disclosed. |
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| IRB approval status: The Partners Human Research Committee approved this study. |
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| Reprints not available from the authors. |
Vol 83 - N° 3
P. 832-838 - septembre 2020 Retour au numéro
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