title: Metastatic basal cell carcinoma: prognosis dependent on anatomic site and spread of disease.
abstract: OBJECTIVE
  This review provides a description of the epidemiology and survival outcomes for cases with metastatic basal cell carcinoma (mBCC) based on published reports (1981-2011).
  
  
  METHODS
  A literature search (MEDLINE via PubMed) was conducted for mBCC case reports published in English: 1981-2011. There were 172 cases that met the following criteria: primary BCC located on skin, metastasis confirmed by pathology and metastasis not resulting from direct tumour spread. From these, 100 mBCC cases with explicit information on follow-up time were selected for analysis. Survival analysis was conducted using Kaplan-Meier methods.
  
  
  RESULTS
  Among 100 mBCC cases selected for analysis, including one case with Gorlin syndrome, 50% had regional metastases (RM) and 50% had distant metastases (DM). Cases with DM were younger at mBCC diagnosis (mean age, 58.0 versus 66.3 years for RM; P=0.0013). Among 93 (of 100) cases with treatment information for metastatic disease, more DM cases received chemotherapy (36.2% versus 6.5% for RM), but more RM cases underwent surgery (87.0% versus 40.4% for DM). Among all 100 cases, median survival after mBCC diagnosis was 54 months (95% confidence interval (CI), 24-72), with shorter survival in DM (24 months; 95% CI, 12-35) versus RM cases (87 months; 95% CI, 63-not evaluable).
  
  
  CONCLUSIONS
  Cases with RM and DM mBCC may have different clinical courses and outcomes. Based on published reports, DM cases were younger at mBCC diagnosis, with shorter median survival than RM cases. This study provides a historical context for emerging mBCC treatments.
authors.affiliation: Genentech, Inc., South San Francisco, CA, USA. Electronic address: Mccusker.Margaret@gene.com.
authors.forename: Margaret
authors.initials: M
authors.lastname: McCusker
authors.affiliation: Hôpital Saint-Louis, Université Paris 7, Paris, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Basset-Seguin
authors.affiliation: University Hospital Zurich, Zurich, Switzerland.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dummer
authors.affiliation: University of Colorado Cancer Center, Denver, CO, USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Lewis
authors.affiliation: University HospitalEssen, Essen, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.affiliation: Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sekulic
authors.affiliation: Genentech, Inc., South San Francisco, CA, USA.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Hou
authors.affiliation: Genentech, Inc., South San Francisco, CA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wang
authors.affiliation: Genentech, Inc., South San Francisco, CA, USA.
authors.forename: Huibin
authors.initials: H
authors.lastname: Yue
authors.affiliation: University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology*; D016019:Survival Analysis
keywords: Carcinoma, basal cell/secondary; Epidemiology; Neoplasm metastasis; Skin neoplasms/pathology; Treatment outcome