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

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 o...

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Vydané v:European journal of cancer (1990) Ročník 118; s. 10 - 34
Hlavní autori: Peris, Ketty, Fargnoli, Maria Concetta, Garbe, Claus, Kaufmann, Roland, Bastholt, Lars, Seguin, Nicole Basset, Bataille, Veronique, Marmol, Veronique del, Dummer, Reinhard, Harwood, Catherine A., Hauschild, Axel, Höller, Christoph, Haedersdal, Merete, Malvehy, Josep, Middleton, Mark R., Morton, Colin A., Nagore, Eduardo, Stratigos, Alexander J., Szeimies, Rolf-Markus, Tagliaferri, Luca, Trakatelli, Myrto, Zalaudek, Iris, Eggermont, Alexander, Grob, Jean Jacques
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Elsevier Ltd 01.09.2019
Elsevier Science Ltd
Predmet:
5-Fluorouracil
Antibodies
Apoptosis
Basal cell carcinoma
Cancer
Carcinoma, Basal Cell - mortality
Carcinoma, Basal Cell - pathology
Carcinoma, Basal Cell - therapy
Cell death
Classification
Clinical Decision-Making
Clinical trials
Consensus
Cryotherapy
Curettage
Dermatology
Destructive therapy
Diagnosis
Europe
Geriatrics
Guidelines
Hedgehog inhibitors
Humans
Imiquimod
Immunotherapy
Laser ablation
Medical diagnosis
Medical Oncology - standards
Metastases
Oncology
Patient Selection
Patients
PD-1 protein
Photodynamic therapy
Predictive Value of Tests
Prognosis
Radiation therapy
Radiotherapy
Risk
Risk Assessment
Risk Factors
Skin
Skin cancer
Skin Neoplasms - mortality
Skin Neoplasms - pathology
Skin Neoplasms - therapy
Surgery
Surgical therapy
Topical therapy
Tumors
Europe
Topical therapy
Basal cell carcinoma
Photodynamic therapy
Surgical therapy
Immunotherapy
Classification
Hedgehog inhibitors
Destructive therapy
Radiotherapy
Guidelines
ISSN:0959-8049, 1879-0852, 1879-0852
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Shrnutí: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. •Basal cell carcinoma (BCC) is the most common epithelial malignant tumour in white populations.•A new classification into “easy-to-treat” (common) BCC and “difficult-to-treat” BCC is proposed.•Surgery is the first-line therapy in all types of BCCs.•Treatment choice for advanced BCC should be discussed by a multidisciplinary tumour board.•Hedgehog inhibitors are used in "difficult-to-treat" BCC, and immunotherapy is a promising treatment under investigation.
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ISSN:0959-8049
1879-0852
1879-0852
DOI:10.1016/j.ejca.2019.06.003