Does wound healing contribute to the eradication of basal cell carcinoma following curettage and electrodessication?
BACKGROUND
Histologic studies indicate that C&D fails to mechanically remove all the tumor in a percentage of cases that far exceeds the 5-year recurrence rate. This raises the question that if C&D does not mechanically remove the tumor in a significant number of patients, why don't we observe tumor recurrence in most of these patients? Our previous study indicates that inflammation occurring over 1 month following C&D does not clear residual tumor. It may be some other process, requiring more time, that clears the residual tumor. Perhaps the proliferative or maturation phase of wound healing or, alternatively, a slow-acting process such as a low-grade immune response set in motion earlier, clears the residual tumor.


OBJECTIVE
To test the hypothesis that wound healing and maturation following C&D clear residual tumor that has not mechanically removed by the procedure.


METHODS
The frequency of residual BCC detected histologically immediately following C&D was compared with the frequency 3 months after the C&D, an amount of time in which the maturation phase of wound healing is well under way.


RESULTS
Twenty-two of 29 primary BCC less than 1 cm in size were tumor-free immediately following the procedure (clearance rate 75.9%). Twelve primary BCC <1 cm were treated by C&D, allowed to heal for 3 months, and then excised and checked histologically. Ten of the twelve BCC were free of tumor, for a clearance rate of 83.3%, which is not a statistically significant difference (p = 0.7187).


CONCLUSIONS
By 3 months, the proliferative phase of wound healing is complete, and our study indicates that this phase has no effect on clearing the tumor. The maturation phase is well under way three months following C&D, and no statistically significant effect was observed.
Nouri
K
K
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami Veterans Affairs Medical Center, Florida, USA.
Spencer
J M
JM
Taylor
J R
JR
Hayag
M
M
DeVoursney
J
J
Shah
N
N
D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D003475:Curettage; D006801:Humans; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology*