TY - JOUR
T1 - European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023
AU - Peris, Ketty
AU - Fargnoli, Maria Concetta
AU - Kaufmann, Roland
AU - Arenberger, Petr
AU - Bastholt, Lars
AU - Seguin, Nicole Basset
AU - Bataille, Veronique
AU - Brochez, Lieve
AU - Del Marmol, Veronique
AU - Dummer, Reinhard
AU - Forsea, Ana-Marie
AU - Gaudy-Marqueste, Caroline
AU - Harwood, Catherine A
AU - Hauschild, Axel
AU - Höller, Christoph
AU - Kandolf, Lidija
AU - Kellerners-Smeets, Nicole W J
AU - Lallas, Aimilios
AU - Leiter, Ulrike
AU - Malvehy, Josep
AU - Marinovic, Branka
AU - Mijuskovic, Zeljko
AU - Moreno-Ramirez, David
AU - Nagore, Eduardo
AU - Nathan, Paul
AU - Stratigos, Alexander J
AU - Stockfleth, Eggert
AU - Tagliaferri, Luca
AU - Trakatelli, Myrto
AU - Vieira, Ricardo
AU - Zalaudek, Iris
AU - Garbe, Claus
AU - EADO”A, EDF”B, ESTRO”C, UEMS”D and EADV”E
PY - 2023/10
Y1 - 2023/10
N2 - Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into 'easy-to-treat' (common) and 'difficult-to-treat' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of 'difficult-to-treat' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
AB - Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into 'easy-to-treat' (common) and 'difficult-to-treat' according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of 'difficult-to-treat' BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.
KW - Basal cell carcinoma
KW - Classification
KW - Destructive therapy
KW - Electrochemotherapy
KW - Gorlin syndrome
KW - Guidelines
KW - Hedgehog inhibitors
KW - Immunotherapy
KW - Photodynamic therapy
KW - Radiation therapy
KW - Surgical therapy
KW - Topical therapy
U2 - 10.1016/j.ejca.2023.113254
DO - 10.1016/j.ejca.2023.113254
M3 - (Systematic) Review article
SN - 0959-8049
VL - 192
JO - European Journal of Cancer
JF - European Journal of Cancer
IS - 1
M1 - 113254
ER -