title: Challenges and new horizons in the management of advanced basal cell carcinoma: a UK perspective.
abstract: Basal cell carcinoma (BCC) is a common malignancy with a good prognosis in the majority of cases. However, some BCC patients develop a more advanced disease that poses significant management challenges. Such cases include locally advanced, recurrent or metastatic BCC, or tumours that occur in anatomical sites where surgical treatment would result in significant deformity. Until recently, treatment options for these patients have been limited, but increased understanding of the molecular basis of BCC has enabled potential therapies, such as hedgehog signalling pathway inhibitors, to be developed. A clear definition of advanced BCC as a distinct disease entity and formal management guidelines have not previously been published, presumably because of the rarity, heterogeneity and lack of treatment options available for the disease. Here we provide a UK perspective from a multidisciplinary group of experts involved in the treatment of complex cases of BCC, addressing the key challenges associated with the perceived definition and management of the disease. With new treatments on the horizon, we further propose a definition for advanced BCC that may be used as a guide for healthcare professionals involved in disease diagnosis and management.
authors.affiliation: MAHSC, Manchester Royal Infirmary, The University of Manchester, 46 Grafton Street, Oxford Road, Manchester M13 9NT, UK.
authors.forename: J T
authors.initials: JT
authors.lastname: Lear
authors.affiliation: Mount Vernon Cancer Centre, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK.
authors.forename: C
authors.initials: C
authors.lastname: Corner
authors.affiliation: St Andrew's Centre for Plastic Surgery and Burns, Broomfield Hospital, Broomfield, Chelmsford, Essex CM1 7ET, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dziewulski
authors.affiliation: Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.
authors.forename: K
authors.initials: K
authors.lastname: Fife
authors.affiliation: Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.
authors.forename: G L
authors.initials: GL
authors.lastname: Ross
authors.affiliation: Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK.
authors.forename: S
authors.initials: S
authors.lastname: Varma
authors.affiliation: Blizard Institute, Barts and The London School of Medicine and Dentistry, 4 Newark Street, London E1 2AT, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Harwood
mesh_terms: D002280:Basal Cell Carcinoma / Q000628:therapy*; D006801:Humans; D012878:Skin Neoplasms / Q000628:therapy*; D006113:United Kingdom