Meta-analysis of published data on incompletely excised basal cell carcinomas of the ear and nose with introduction of an innovative treatment strategy.
BACKGROUND
Auricular/nasal basal cell carcinomas (BCC) often require more surgical procedures than BCCs at other sites.


METHODS
A meta-analysis of incompletely excised BCCs compares those on the ear and nose to other sites. The combination of photodynamic diagnostics (PDD) and fresh-frozen sections is compared to multi-stage excisions; in each case, the tissue margins were histographically controlled.


RESULTS
The relative risk of an incomplete excision of a BCC on the ear/nose is 2.5 fold higher than on the rest of the body. The combination of PDD and micrographic surgery with fresh-frozen sections reduces the length of stay by 42.86 % from median 14 d to 8 d as well as increasing the revenue per patient per day by 41.9 % from 320.61 euro to 454.95 euro with nearly a comparable rate of recurrences after one year.


CONCLUSIONS
PDD in combination with single-stage surgery is an equivalent therapy with few side effects and conforming to guidelines. It takes into account both quality assurance and patient preferences. Multicenter, randomized trials seem desirable.
Rogalski
Christina
C
Department of Dermatology, Venereology and Allergy, University of Leipzig, Germany. christina.rogalski@medizin.uni-leipzig.de
Kauer
Friederike
F
Simon
Jan Christoph
JC
Paasch
Uwe
U
D002280:Basal Cell Carcinoma / Q000453:epidemiology* / Q000628:therapy*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D006801:Humans; D015580:Mohs Surgery / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010506:Periodicals as Topic / Q000706:statistics & numerical data; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome