title: Intralesional cryosurgery for the treatment of basal cell carcinoma of the lower extremities in elderly subjects: a feasibility study.
abstract: BACKGROUND
  Incidences of basal cell carcinoma (BCC) on the lower extremities in elderly patients are rising. Surgical approaches to the treatment of BCC are subject to possible difficulties in healing, failure of skin grafts, and wound infection. This study assessed the efficacy of intralesional cryosurgery in the treatment of BCC of the lower limbs in elderly patients.
  
  
  METHODS
  This study included eight patients aged >60 years in whom a total of 10 nodular or superficial BCCs of the lower limbs were confirmed by biopsy. The patients' medical histories revealed comorbidities including hypertension, diabetes, hypercholesterolemia, venous insufficiency, and deep vein thrombosis of the legs, congestive heart failure, chronic renal failure, and ischemic heart disease. Using liquid nitrogen, an intralesional cryosurgery needle (CryoShape) was inserted into the tumor to facilitate its complete freezing. Treatment success was confirmed by biopsy taken approximately 3 months after complete healing of the cryo-wound.
  
  
  RESULTS
  The average size of the lesions treated was 2.49 cm(2) (16.4 × 15.2 mm). Mean recovery time was 79.9 days. Biopsies were obtained at a mean of 85.3 days after the wound had healed. All 10 biopsies verified the complete destruction of the tumor. There was no evidence of wound infection or tumor recurrence over a follow-up period of 28 months.
  
  
  CONCLUSIONS
  This study demonstrates that a single intralesional cryosurgery session can completely eradicate BCC on the lower extremities in elderly patients. This technique is associated with relatively minor complications, is well tolerated, and represents a safe and effective therapeutic modality for BCC of the lower limbs.
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Har-Shai
authors.affiliation: Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Adir
authors.initials: A
authors.lastname: Sommer
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Gil
authors.affiliation: Department of Pathology, Ha-Emek Medical Center, Afula, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Judit
authors.initials: J
authors.lastname: Krausz
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Gal-Or
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Issa
authors.initials: I
authors.lastname: Mettanes
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Idit
authors.initials: I
authors.lastname: Lavi
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Eyal
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Leonid
authors.initials: L
authors.lastname: Brizgalin
authors.affiliation: Unit of Plastic Surgery, Carmel Medical Center, Haifa, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Taran
authors.affiliation: Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Har-Shai
authors.affiliation: Department of Pathology, Ha-Emek Medical Center, Afula, Israel.|Bruce Rappaport Faculty of Medicine, Israel Institute of Technology (Technion), Haifa, Israel.
authors.forename: Irit
authors.initials: I
authors.lastname: Elmalach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome