title: Photodynamic therapy versus surgical excision to basal cell carcinoma: meta-analysis.
abstract: BACKGROUND
  Surgical excision (SE) is a first-line treatment for basal cell carcinoma (BCC). Topical photodynamic therapy (PDT) has also been used and has cosmetic advantages over surgery. The latest European guidelines for topical PDT recommended that it be used to treat nodular basal cell carcinoma (nBCC) but a consensus has not been reached. Our study was to evaluate the efficacy of PDT versus SE for the treatment for nBCC by a meta-analysis.
  
  
  METHODS
  We searched PubMed, EMBASE, the Cochrane Library, CKNI, VIP, and relevant references up to October 2014 including randomized controlled trials (RCTs) that compared PDT with SE for treatment of nBCC patients. A meta-analysis was conducted by using the Cochrane Collaboration's revman 5.0 software.
  
  
  RESULTS
  We selected five studies that covered 596 of pathologically confirmed nBCC. We compared complete response rate (RR) of PDT and SE at 3 months and 1, 2, 3, 4, and 5 years. We found that the RR was 0.95 (0.90, 1.00), 0.89 (0.80, 0.99), 0.83 (0.69, 1.00), 0.73 (0.63, 0.85), 0.84 (0.65, 1.08), and 0.79 (0.61, 1.03), respectively, for those time points, the cumulative probability of recurrence for the time points post-treatment, with an estimate at RR 5.28 (1.85, 15.12), 6.48 (2.46, 17.09), 9.67 (3.02, 30.99), 7.73 (2.81, 21.28), and 8.25 (3.01-22.62), respectively.
  
  
  CONCLUSIONS
  We observed no significant differences between PDT and SE for the complete RR, but there was an increased cumulative probability of recurrence. More large-scale RCTs are required to verify our findings.
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Yurui
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Yunxiang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Rheumatology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Yu
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Luo
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Jiangbo
authors.initials: J
authors.lastname: Han
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Zhijia
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.
authors.forename: Jintao
authors.initials: J
authors.lastname: Li
authors.affiliation: Institute of Tropical Medicine, Third Military Medical University, Chongqing, China.|Department of Epidemiology, Third Military Medical University, Chongqing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Lin
mesh_terms: D000622:Aminolevulinic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D002280:Basal Cell Carcinoma / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid
keywords: meta-analysis; nodular basal cell carcinoma; surgical excision; topical photodynamic therapy