Preoperative evaluation of high-risk basal cell carcinoma with line-field confocal optical coherence tomography (LC-OCT) reduces Mohs micrographic surgery stage number: A case-control study
Mohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation with line field confocal optical coherence tomography (LC-OCT) is expected to reduce MMS stages number. to investigate the effectiveness of LC-OCT preop...
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| Vydané v: | EJC skin cancer Ročník 2; s. 100015 |
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| Hlavní autori: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Elsevier Ltd
01.12.2024
Elsevier |
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| ISSN: | 2772-6118, 2772-6118 |
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| Abstract | Mohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation with line field confocal optical coherence tomography (LC-OCT) is expected to reduce MMS stages number.
to investigate the effectiveness of LC-OCT preoperative evaluation of high-risk BCC margins in reducing the number of MMS stages to achieve tumor clearance.
high-risk BCC patients undergoing MMS at Policlinico A. Gemelli Foundation, IRCCS – Rome during January 2018 – December 2022. The LC-OCT group included patients undergoing preoperative lateral tumor margin demarcation by clinical, dermoscopic, and LC-OCT examination; patients in the control group underwent preoperative lateral tumor margin demarcation by clinical and dermoscopic examination only. LC-OCT imaging was compared to MMS histopathological sections.
63 facial high-risk BCCs from 60 patients, mean age of 68.3 years (SD 11.9). The LC-OCT and the control group included 22 and 41 BCCs, respectively. LC-OCT imaging showed almost perfect agreement with histopathology for low- versus high-risk of recurrence BCC histopathological subtypes discrimination (Cohen’s kappa 0.88). We reported a significant difference in the mean number of MMS stages between the LC-OCT and the control group (1.23 ± 0.43 SD, and 1.89 ± 1.05 SD, respectively; p-value =0.007). At univariate regression analysis, LC-OCT preoperative mapping of BCC tumor margins significantly reduced patients’ risk of undergoing >1 MMS stage (crude odds ratio [ORc]: 0.3 95% CI 0.1–0.8, p-value =0.032).
LC-OCT preoperative evaluation of high-risk BCC margins significantly reduced the number of MMS stages to achieve tumor clearance.
•LC-OCT preoperative evaluation of BCC margins reduces the number of Mohs stages.•LC-OCT imaging shows a strong agreement with BCC histopathological examination.•LC-OCT is useful also for aggressive BCC histopathological subtypes evaluation. |
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| AbstractList | Background: Mohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation with line field confocal optical coherence tomography (LC-OCT) is expected to reduce MMS stages number. Objective: to investigate the effectiveness of LC-OCT preoperative evaluation of high-risk BCC margins in reducing the number of MMS stages to achieve tumor clearance. Patients and methods: high-risk BCC patients undergoing MMS at Policlinico A. Gemelli Foundation, IRCCS – Rome during January 2018 – December 2022. The LC-OCT group included patients undergoing preoperative lateral tumor margin demarcation by clinical, dermoscopic, and LC-OCT examination; patients in the control group underwent preoperative lateral tumor margin demarcation by clinical and dermoscopic examination only. LC-OCT imaging was compared to MMS histopathological sections. Results: 63 facial high-risk BCCs from 60 patients, mean age of 68.3 years (SD 11.9). The LC-OCT and the control group included 22 and 41 BCCs, respectively. LC-OCT imaging showed almost perfect agreement with histopathology for low- versus high-risk of recurrence BCC histopathological subtypes discrimination (Cohen’s kappa 0.88). We reported a significant difference in the mean number of MMS stages between the LC-OCT and the control group (1.23 ± 0.43 SD, and 1.89 ± 1.05 SD, respectively; p-value =0.007). At univariate regression analysis, LC-OCT preoperative mapping of BCC tumor margins significantly reduced patients’ risk of undergoing >1 MMS stage (crude odds ratio [ORc]: 0.3 95% CI 0.1–0.8, p-value =0.032). Conclusion: LC-OCT preoperative evaluation of high-risk BCC margins significantly reduced the number of MMS stages to achieve tumor clearance. Mohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation with line field confocal optical coherence tomography (LC-OCT) is expected to reduce MMS stages number. to investigate the effectiveness of LC-OCT preoperative evaluation of high-risk BCC margins in reducing the number of MMS stages to achieve tumor clearance. high-risk BCC patients undergoing MMS at Policlinico A. Gemelli Foundation, IRCCS – Rome during January 2018 – December 2022. The LC-OCT group included patients undergoing preoperative lateral tumor margin demarcation by clinical, dermoscopic, and LC-OCT examination; patients in the control group underwent preoperative lateral tumor margin demarcation by clinical and dermoscopic examination only. LC-OCT imaging was compared to MMS histopathological sections. 63 facial high-risk BCCs from 60 patients, mean age of 68.3 years (SD 11.9). The LC-OCT and the control group included 22 and 41 BCCs, respectively. LC-OCT imaging showed almost perfect agreement with histopathology for low- versus high-risk of recurrence BCC histopathological subtypes discrimination (Cohen’s kappa 0.88). We reported a significant difference in the mean number of MMS stages between the LC-OCT and the control group (1.23 ± 0.43 SD, and 1.89 ± 1.05 SD, respectively; p-value =0.007). At univariate regression analysis, LC-OCT preoperative mapping of BCC tumor margins significantly reduced patients’ risk of undergoing >1 MMS stage (crude odds ratio [ORc]: 0.3 95% CI 0.1–0.8, p-value =0.032). LC-OCT preoperative evaluation of high-risk BCC margins significantly reduced the number of MMS stages to achieve tumor clearance. •LC-OCT preoperative evaluation of BCC margins reduces the number of Mohs stages.•LC-OCT imaging shows a strong agreement with BCC histopathological examination.•LC-OCT is useful also for aggressive BCC histopathological subtypes evaluation. |
| ArticleNumber | 100015 |
| Author | Paradisi, Andrea Federico, Francesco Cappilli, Simone Di Stefani, Alessandro Mannino, Maria Cornacchia, Luigi Abeni, Damiano Peris, Ketty |
| Author_xml | – sequence: 1 givenname: Andrea surname: Paradisi fullname: Paradisi, Andrea email: aparad78@gmail.com organization: UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy – sequence: 2 givenname: Luigi surname: Cornacchia fullname: Cornacchia, Luigi organization: Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy – sequence: 3 givenname: Simone surname: Cappilli fullname: Cappilli, Simone organization: UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy – sequence: 4 givenname: Damiano surname: Abeni fullname: Abeni, Damiano organization: Laboratorio di Epidemiologia Clinica, IDI-IRCCS, Rome, Italy – sequence: 5 givenname: Francesco surname: Federico fullname: Federico, Francesco organization: Department of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy – sequence: 6 givenname: Alessandro surname: Di Stefani fullname: Di Stefani, Alessandro organization: UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy – sequence: 7 givenname: Maria surname: Mannino fullname: Mannino, Maria organization: UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy – sequence: 8 givenname: Ketty surname: Peris fullname: Peris, Ketty organization: UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy |
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| CitedBy_id | crossref_primary_10_3390_jpm15060226 crossref_primary_10_1093_skinhd_vzae025 crossref_primary_10_1111_ddg_15827 crossref_primary_10_3390_jcm13133830 crossref_primary_10_1111_ijd_17496 crossref_primary_10_3390_dermatopathology11040033 crossref_primary_10_3390_diagnostics14161821 crossref_primary_10_1007_s00105_025_05563_4 |
| Cites_doi | 10.1364/BOE.10.000694 10.1016/j.jaad.2019.02.058 10.1080/09546634.2020.1762839 10.1016/j.jaad.2019.02.049 10.1016/j.jaad.2018.02.083 10.1111/srt.12407 10.1590/abd1806-4841.20187089 10.1016/j.det.2016.05.012 10.1001/jamadermatol.2017.1450 10.1016/j.jaad.2017.10.006 10.1111/jdv.18800 10.1016/j.jaad.2019.10.028 10.1016/j.jaad.2021.11.010 10.1111/dth.15832 10.1016/j.ejca.2019.06.003 10.1016/j.jaad.2020.04.008 10.1111/jdv.17078 10.1111/bjd.15903 10.1016/j.ejca.2021.04.029 10.1016/j.jid.2016.02.012 10.1111/jdv.18038 10.1111/bjd.20524 |
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| Keywords | Mohs micrographic surgery Surgical margins Diagnostic imaging Line-field confocal optical coherence tomography High-risk basal cell carcinoma |
| Language | English |
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| Snippet | Mohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation with line... Background: Mohs micrographic surgery (MMS) is the preferred surgical approach for high-risk basal cell carcinoma (BCC). Pre-surgical tumor margins delineation... |
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| SubjectTerms | Diagnostic imaging High-risk basal cell carcinoma Line-field confocal optical coherence tomography Mohs micrographic surgery Surgical margins |
| Title | Preoperative evaluation of high-risk basal cell carcinoma with line-field confocal optical coherence tomography (LC-OCT) reduces Mohs micrographic surgery stage number: A case-control study |
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