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Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung

BACKGROUND: Basal cell carcinomas are the most frequent epithelial skin tumors and a frequent indication for dermatological interventions. Despite the establishment of drug treatment options, surgery is still the treatment of choice. Various options are available ranging from curettage to complex de...

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Autores principales: Kofler, Lukas, Häfner, Hans-Martin, Schulz, Claudia, Eichner, Martin, Kofler, Katrin, Schnabl, Saskia Maria, Breuninger, Helmut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686215/
https://www.ncbi.nlm.nih.gov/pubmed/32930855
http://dx.doi.org/10.1007/s00105-020-04685-1
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author Kofler, Lukas
Häfner, Hans-Martin
Schulz, Claudia
Eichner, Martin
Kofler, Katrin
Schnabl, Saskia Maria
Breuninger, Helmut
author_facet Kofler, Lukas
Häfner, Hans-Martin
Schulz, Claudia
Eichner, Martin
Kofler, Katrin
Schnabl, Saskia Maria
Breuninger, Helmut
author_sort Kofler, Lukas
collection PubMed
description BACKGROUND: Basal cell carcinomas are the most frequent epithelial skin tumors and a frequent indication for dermatological interventions. Despite the establishment of drug treatment options, surgery is still the treatment of choice. Various options are available ranging from curettage to complex dermatosurgical procedures. In addition to the main aspect of low local recurrence rates, esthetic factors and the number of procedures are also important for the choice of treatment. METHODS: In this study 347 patients with 398 basal cell carcinomas (nodular type, diameter up to 10 mm) were prospectively examined. The patients were randomized into two treatment arms: in one group the tumor was treated by ring curettage and in the other group the tumor was excised. Patients who underwent 3D histologically controlled surgery due to basal cell carcinoma during the same investigation period served as controls. RESULTS: The highest local recurrence rate was observed after curettage (14.0%), whereas the group with 3D histology had the lowest recurrence rate (0.9%, p < 0.001). In the 3D group, more re-excisions were required to achieve complete tumor clearance compared to the group who underwent excisions with serial section histology. Patients rated the esthetic outcome best after curettage. The median follow-up was 3.9 years. CONCLUSION: The choice of surgical treatment for small nodular basal cell carcinomas depends on individual circumstances. Excisions controlled by 3D histology with wound closure after complete tumor clearance showed the lowest recurrence rate in our study; however, curettage is also a possible surgical treatment option with minimal effort and an acceptable recurrence rate, which can lead to good esthetic results.
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spelling pubmed-76862152020-11-30 Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung Kofler, Lukas Häfner, Hans-Martin Schulz, Claudia Eichner, Martin Kofler, Katrin Schnabl, Saskia Maria Breuninger, Helmut Hautarzt Originalien BACKGROUND: Basal cell carcinomas are the most frequent epithelial skin tumors and a frequent indication for dermatological interventions. Despite the establishment of drug treatment options, surgery is still the treatment of choice. Various options are available ranging from curettage to complex dermatosurgical procedures. In addition to the main aspect of low local recurrence rates, esthetic factors and the number of procedures are also important for the choice of treatment. METHODS: In this study 347 patients with 398 basal cell carcinomas (nodular type, diameter up to 10 mm) were prospectively examined. The patients were randomized into two treatment arms: in one group the tumor was treated by ring curettage and in the other group the tumor was excised. Patients who underwent 3D histologically controlled surgery due to basal cell carcinoma during the same investigation period served as controls. RESULTS: The highest local recurrence rate was observed after curettage (14.0%), whereas the group with 3D histology had the lowest recurrence rate (0.9%, p < 0.001). In the 3D group, more re-excisions were required to achieve complete tumor clearance compared to the group who underwent excisions with serial section histology. Patients rated the esthetic outcome best after curettage. The median follow-up was 3.9 years. CONCLUSION: The choice of surgical treatment for small nodular basal cell carcinomas depends on individual circumstances. Excisions controlled by 3D histology with wound closure after complete tumor clearance showed the lowest recurrence rate in our study; however, curettage is also a possible surgical treatment option with minimal effort and an acceptable recurrence rate, which can lead to good esthetic results. Springer Medizin 2020-09-15 2020 /pmc/articles/PMC7686215/ /pubmed/32930855 http://dx.doi.org/10.1007/s00105-020-04685-1 Text en © The Author(s) 2020 Open Access. Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden. Die in diesem Artikel enthaltenen Bilder und sonstiges Drittmaterial unterliegen ebenfalls der genannten Creative Commons Lizenz, sofern sich aus der Abbildungslegende nichts anderes ergibt. Sofern das betreffende Material nicht unter der genannten Creative Commons Lizenz steht und die betreffende Handlung nicht nach gesetzlichen Vorschriften erlaubt ist, ist für die oben aufgeführten Weiterverwendungen des Materials die Einwilligung des jeweiligen Rechteinhabers einzuholen. Weitere Details zur Lizenz entnehmen Sie bitte der Lizenzinformation auf http://creativecommons.org/licenses/by/4.0/deed.de.
spellingShingle Originalien
Kofler, Lukas
Häfner, Hans-Martin
Schulz, Claudia
Eichner, Martin
Kofler, Katrin
Schnabl, Saskia Maria
Breuninger, Helmut
Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung
title Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung
title_full Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung
title_fullStr Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung
title_full_unstemmed Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung
title_short Chirurgische Techniken in der Therapie des Basalzellkarzinoms – eine prospektive Untersuchung
title_sort chirurgische techniken in der therapie des basalzellkarzinoms – eine prospektive untersuchung
topic Originalien
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686215/
https://www.ncbi.nlm.nih.gov/pubmed/32930855
http://dx.doi.org/10.1007/s00105-020-04685-1
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