Non-melanoma skin cancer recurrence, low after curettage…

Nonmelanoma skin cancer (NMSC)  (which includes common skin cancers such as basal cell carcinoma, BCC and squamous cell carcinoma, SCC) patients have a less than 5% long-term recurrence rate after treatment using three different techniques, suggest study findings.

There are different ways to remove a skin cancer. The method used by a Dr depends on various factors. Patient factors, of course, are paramount. These include the nature of the skin cancer, size and site of the spot. Doctor factors, such as the Dr’s experience and specialty, however, are also important.

Curettage (aka electrodessication and curettage), for instance, is primarily a method of removing small skin cancer (usually in areas outside the face) pioneered by Dermatologists. It is a quick, safe and economical procedure with excellent cosmetic outcome when chosen and performed in experienced hands.

This research team found that the recurrence rate following electrodessication and curettage (ED&C) was lower than expected and that after Mohs surgery (a special form of skin cancer surgery which mapped the margin of the skin cancer removed) it was higher than expected.

Mary-Margaret Chren (San Francisco VA Medical Center, California, USA) and co-workers evaluated tumor recurrence over a median of 6.6 years in 495 patients with 608 NMSCs (basal or squamous cell carcinomas) treated with ED&C (127 tumors), excision (309 tumors), or Mohs surgery (172 tumors).

A large majority of the patients (97%) were men and their mean age at diagnosis of NMSC was 71 years.

Writing in the Archives of Dermatology, the researchers report that over the follow-up period, 21 (3.5%) of the tumors recurred. Of these, 1.6% had been treated with ED&C, 4.2% with excision, and 3.5% with Mohs surgery.

“This study is important for a number of reasons,” said editorialist Kenneth Tsai (University of Texas MD Anderson Cancer Center, Houston, USA).

“First, its prospective nature and precise definition of recurrence, with histologic confirmation, confers a substantial advantage over previous studies… Importantly, the study also controlled for amount of patient follow-up, since this could certainly affect the detection of recurrence,” he said.

“The study also reinforces the notion that the appropriate time-frame for assessing recurrences of NMSC following treatment is longer than 5 years,” he added.

Chren and colleagues conclude: “These results fill a gap in current knowledge about treatment of NMSC.”

Arch Dermatol 2011: 147: 540–546, 605–606, MedWire 2011, Ken Ho

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