title: Long-term recurrence of nonmelanoma skin cancer after topical methylaminolevulinate photodynamic therapy in a dermato-oncology department.
abstract: BACKGROUND
  Most available studies on the efficacy of topical photodynamic therapy focus on short-to medium-term results. Long-term data are scarce.
  
  
  OBJECTIVE
  To evaluate the long-term efficacy of photodynamic therapy with topical methylaminolevulinate to treat Bowen's disease and basal cell carcinoma in the clinical practice setting of a dermato-oncology department.
  
  
  METHODS
  The study included patients diagnosed with Bowen's disease or basal cell carcinoma, and who received photodynamic therapy from 2004 to 2008. Treatment protocol and clinical follow-up were standardized. The primary endpoint was clinically observed recurrence in a previous photodynamic therapy-treated area. Descriptive and survival analyses were performed.
  
  
  RESULTS
  A total of 31 Bowen's disease lesions and 44 superficial basal cell carcinoma were treated, with a median follow-up of 43.5 months. Recurrence was observed in 14 Bowen's disease lesions (53.8%) and in 11 superficial basal cell carcinoma (33.3%). Significantly higher estimates for recurrence rates were found in patients with Bowen's disease (p=0.0036) or those aged under 58 years (p=0.039). The risk of recurrence was higher in patients with Bowen's disease than in those with superficial basal cell carcinoma and younger patients.
  
  
  CONCLUSIONS
  Recurrence should be considered when choosing to treat non-melanoma skin cancer with photodynamic therapy. Younger age and Bowen's disease were independent predictors for long-term recurrence, suggesting the need to establish an extended period of follow-up for this subset of patients.
authors.affiliation: Hospital de Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Cabete
authors.affiliation: Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Rafael
authors.affiliation: Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
authors.forename: Mariana
authors.initials: M
authors.lastname: Cravo
authors.affiliation: Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
authors.forename: Cecília
authors.initials: C
authors.lastname: Moura
authors.affiliation: Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Sachse
authors.affiliation: Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pecegueiro
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001913:Bowen's Disease / Q000188:drug therapy*; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid