Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines.

{"article_title":"Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines.","author":"Peris K, Fargnoli MC, Garbe C, Kaufmann R, Bastholt L, Seguin NB, Bataille V, Marmol VD, Dummer R, Harwood CA, Hauschild A, H\u00f6ller C, Haedersdal M, Malvehy J, Middleton MR, Morton CA, Nagore E, Stratigos AJ, Szeimies RM, Tagliaferri L, Trakatelli M, Zalaudek I, Eggermont A, Grob JJ","journal_title":"European journal of cancer (Oxford, England : 1990)","issn":"1879-0852","isbn":"","publication_date":"2019-09-01","volume":"118","issue":"","first_page":"10","page_count":"","accession_number":"31288208","doi":"10.1016\/j.ejca.2019.06.003","publisher":"Elsevier Science Ltd","doctype":"Consensus Development Conference","subjects":"Europe; Carcinoma, Basal Cell therapy; Medical Oncology standards; Skin Neoplasms therapy; Carcinoma, Basal Cell mortality; Carcinoma, Basal Cell pathology; Clinical Decision-Making; Consensus; Europe; Humans; Patient Selection; Predictive Value of Tests; Prognosis; Risk Assessment; Risk Factors; Skin Neoplasms mortality; Skin Neoplasms pathology","interest_area":["Oncology"],"abstract":"Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer collaborated to develop recommendations on diagnosis and treatment of BCC. A new classification into 'easy-to-treat (common) BCC and 'difficult-to-treat' BCC is proposed. Diagnosis is based on clinicodermatoscopic features for 'easy-to-treat' BCCs. Histopathological confirmation is mandatory in ambiguous lesions and in BCCs located in high-risk areas. The first-line treatment of 'easy-to-treat' BCC is complete surgery. Microscopically controlled surgery shall be offered for high-risk BCC, recurrent BCC and BCC in critical anatomical sites. Topical therapies (5% imiquimod, 5% fluorouracil) and destructive approaches (curettage, electrocautery, cryotherapy, laser ablation) should be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial BCC and thin nodular BCC. The therapy for a 'difficult-to-treat' BCC should preferentially be discussed by a multidisciplinary tumour board. Hedgehog inhibitors, vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCCs. Immunotherapy with anti-programmed cell death 1 (PD-1) antibodies is a promising therapeutic option, currently being investigated in clinical trials. Radiotherapy represents a valid alternative to surgery for BCC on the face, especially in elderly patients. In patients with naevoid basal cell carcinoma syndrome (NBCCS), close surveillance and regular skin examinations are required to diagnose and treat BCCs at early stage. Long-term follow-up is recommended in patients with high-risk BCC subtypes, high-risk sites, multiple BCCs and NBCCS. Copyright \u00a9 2019 Elsevier Ltd. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=31288208","isPdfLink":false,"isSAML":false,"an":"31288208","number_other":"","type_pub":"","issn_electronic":"1879-0852","languages":"English","language":"eng","date_entry":"Date Created: 20190710 Date Completed: 20200608 Latest Revision: 20210212","date_update":"20240105","titleSource":"European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2019 Sep; Vol. 118, pp. 10-34. Date of Electronic Publication: 2019 Jul 06.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2019-09-01","description":"Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer collaborated to develop recommendations on diagnosis and treatment of BCC. A new classification into 'easy-to-treat (common) BCC and 'difficult-to-treat' BCC is proposed. Diagnosis is based on clinicodermatoscopic features for 'easy-to-treat' BCCs. Histopathological confirmation is mandatory in ambiguous lesions and in BCCs located in high-risk areas. The first-line treatment of 'easy-to-treat' BCC is complete surgery. Microscopically controlled surgery shall be offered for high-risk BCC, recurrent BCC and BCC in critical anatomical sites. Topical therapies (5% imiquimod, 5% fluorouracil) and destructive approaches (curettage, electrocautery, cryotherapy, laser ablation) should be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial BCC and thin nodular BCC. The therapy for a 'difficult-to-treat' BCC should preferentially be discussed by a multidisciplinary tumour board. Hedgehog inhibitors, vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCCs. Immunotherapy with anti-programmed cell death 1 (PD-1) antibodies is a promising therapeutic option, currently being investigated in clinical trials. Radiotherapy represents a valid alternative to surgery for BCC on the face, especially in elderly patients. In patients with naevoid basal cell carcinoma syndrome (NBCCS), close surveillance and regular skin examinations are required to diagnose and treat BCCs at early stage. Long-term follow-up is recommended in patients with high-risk BCC subtypes, high-risk sites, multiple BCCs and NBCCS.<br \/> (Copyright © 2019 Elsevier Ltd. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=31288208&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Peris K, Fargnoli MC, Garbe C, Kaufmann R, Bastholt L, Seguin NB, Bataille V, Marmol VD, Dummer R, Harwood CA, Hauschild A, H\u00f6ller C, Haedersdal M, Malvehy J, Middleton MR, Morton CA, Nagore E, Stratigos AJ, Szeimies RM, Tagliaferri L, Trakatelli M, Zalaudek I, Eggermont A, Grob JJ"}