Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2004 Sep 25;329(7468):705.
doi: 10.1136/bmj.38219.515266.AE. Epub 2004 Sep 13.

Interventions for basal cell carcinoma of the skin: systematic review

Fiona Bath-Hextall  1 , Jan Bong, William Perkins, Hywel Williams
Affiliations
Review

Interventions for basal cell carcinoma of the skin: systematic review

Fiona Bath-Hextall et al. BMJ. .

Abstract

Objectives: To assess the effects of treatments for basal cell carcinoma.

Methods: Systematic review of randomised controlled trials.

Main outcome measure: Recurrence of basal cell carcinoma at three years or beyond, assessed clinically.

Studies reviewed: Randomised controlled trials of interventions for histologically confirmed basal cell carcinoma (published and unpublished material; no language restrictions).

Results: 25 studies were identified, covering seven therapeutic categories. Only one study of surgical excision versus radiotherapy contained primary outcome data, which showed significantly more persistent tumours and recurrences in the radiotherapy group compared with surgery (odds ratio 0.09, 95% confidence interval 0.01 to 0.67). One study compared cryotherapy with surgery, with inconclusive results at one year. In a comparison of radiotherapy with cryotherapy, significantly more recurrences occurred at one year in the cryotherapy group. Preliminary studies suggest a short term success rate of 87-88% for imiquimod cream in the treatment of superficial basal cell carcinoma, although this cream has not been compared with surgery. No consistent evidence was found for the other treatment modalities.

Conclusions: Little good quality research has been done on the treatments used for the most common cancer in humans. Most trials have included only people with basal cell carcinoma occurring at low risk sites. Only one trial measured recurrence at four years; recurrence rates at one year should be interpreted with caution. Surgery and radiotherapy seem to be the most effective treatments; surgery showed the lowest failure rates. Other treatments might have some use but need to be compared with surgery.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Flowchart of studies included in the review. BCC=basal cell carcinoma; BEC-5=mixture of 0.005% solasodine glycosides found in solanaceous plants (aubergine)
Fig 2
Fig 2
Early treatment failure within six months measured histologically. BEC-5=mixture of 0.005% solasodine glycosides found in solanaceous plants (aubergine)
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Telfer N, Colver G, Bowers P. Guidelines for the management of basal cell carcinoma. Br J Dermatol 1999;141: 415-23. - PubMed
    1. Preston D, Stern R. Nonmelanoma cancers of the skin. N Engl J Med 1992;327: 1649-62. - PubMed
    1. Miller S. Biology of basal cell carcinoma (part 1). J Am Acad Dermatol 1991;24: 1-13. - PubMed
    1. Lo J, Snow S, Reizner G. Metastatic basal cell carcinoma: report of twelve cases with a review of the literature. J Am Acad Dermatol 1991;24: 715-9. - PubMed
    1. Breuninger H, Dietz K. Prediction of subclinical tumor infiltration in basal cell carcinoma. J Dermatol Surg Oncol 1991;17: 574-8. - PubMed

Substances