Tumor thickness and adnexal extension of superficial basal cell carcinoma (sBCC) as determinants of treatment failure for methylaminolevulinate (MAL)-photodynamic therapy (PDT), imiquimod, and 5-fluorouracil (FU).
BACKGROUND
Noninvasive treatments are frequently used in treatment of superficial basal cell carcinoma (sBCC) because of better cosmetic results, lower costs, and less burden on health care services when compared with surgical excision. However, probability of treatment failure is higher after noninvasive therapies and may depend on histologic tumor characteristics.


OBJECTIVE
We sought to investigate whether tumor thickness and adnexal extension are determinants of treatment failure in sBCC treated with topical methylaminolevulinate-photodynamic therapy, imiquimod, or 5-fluorouracil.


METHODS
Data were derived from a randomized controlled trial on the effectiveness of methylaminolevulinate photodynamic therapy, imiquimod, and 5-fluorouracil for treatment of sBCC (ISRCTN79701845). For tumors with treatment failure (n = 112) and a randomly selected control group of tumors without treatment failure (n = 224) data on tumor thickness and adnexal extension were retrospectively collected. Treatment failure was defined as a clinically and histologically persistent or recurrent tumor within 1-year posttreatment.


RESULTS
Tumor thickness of included patients ranged from 0.2 to 1.0 mm. Tumor thickness and adnexal extension of sBCC were not significantly associated with treatment failure of methylaminolevulinate photodynamic therapy, imiquimod, or 5-fluorouracil.


CONCLUSIONS
Follow-up period of 1 year is a limitation.


CONCLUSIONS
There seems to be no need to determine tumor thickness or adnexal extension in sBCC before treatment.
Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands; GROW Research Institute for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. Electronic address: mh.roozeboom@mumc.nl.
Marieke H
MH
Roozeboom
Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands.
Lotte
L
van Kleef
Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands; GROW Research Institute for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Aimee H M M
AH
Arits
Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands; GROW Research Institute for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Klara
K
Mosterd
Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands.
Veronique J L
VJ
Winnepenninckx
Department of Pathology, VieCuri Medical Center, Venlo, The Netherlands.
Arienne M W
AM
van Marion
Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
Patty J
PJ
Nelemans
Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands; GROW Research Institute for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
Nicole W J
NW
Kelleners-Smeets
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000627:therapeutic use*; D000634:Aminoquinolines / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D000077271:Imiquimod; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017211:Treatment Failure; D047368:Tumor Burden
D000634:Aminoquinolines; D000970:Antineoplastic Agents; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; D000077271:Imiquimod; D005472:Fluorouracil
5-fluorouracil; adnexal extension; determinants; imiquimod; photodynamic therapy; superficial basal cell carcinoma; thickness; treatment