Meta-analysis: surgery, Mohs most effective for basal cell carcinoma

  • Fukumoto T & al.
  • J Eur Acad Dermatol Venereol
  • 13 Jul 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Invasive treatments such as surgery and Mohs micrographic surgery yield lower rates of treatment failure than superficial therapies for basal cell carcinoma (BCC), according to a systematic review and meta-analysis.

Why this matters

  • With so many choices, the optimal treatment strategies for BCC are unclear; invasive treatments such as surgery are standard.

Key results

  • In patient-level analysis, imiquimod (OR, 12.29; 95% CI, 4.83-31.26), cryotherapy (OR, 19.91; 95% CI, 6.73-58.90), 5-fluorouracil (OR, 22.37; 95% CI, 8.29-60.33), and photodynamic therapy (PDT: OR, 30.49; 95% CI, 11.47-81.04) were associated with higher odds of treatment failure compared with surgery.
  • In tumor-level analysis, cryotherapy (OR, 4.06; 95% CI, 1.65-9.98) and PDT (OR, 10.30; 95% CI, 4.66-22.74) were associated with higher odds of treatment failure compared with surgery.
    • Mohs micrographic surgery (OR, 0.50, 95% CI 0.24-1.03) had the lowest odds for treatment failure.
  • Similar results were found when analyzing for odds of treatment success.

Study design

  • 14 studies (2524 patients) were included in the meta-analysis.
  • Funding: None disclosed.

Limitations

  • Risk for bias in included studies.