Clinical factors predictive for histological aggressiveness of basal cell carcinoma: A prospective study of 2274 cases |
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| Authors: | J.-M. Amici L. Dousset M. Battistella B. Vergier J.-Y. Bailly O. Cogrel L. Gusdorf C. Alfaro K. Ezzedine B. Cribier M. Beylot-Barry |
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| Affiliation: | 1. Department of Dermatology, Oncodermatology and Interventional Dermatology, Bordeaux University Hospital, Saint-André Hospital, 1, rue Jean-Burguet, 33075 Bordeaux cedex, France;2. Pathology Laboratory, Saint-Louis Hospital, Public Assistance-Paris Hospitals (AP–HP), Paris, France;3. Pathology Laboratory, Bordeaux University Hospital, Bordeaux, France;4. Inserm Unit U1053, Bordeaux Research in Translational Oncology, Bordeaux University, Bordeaux, France;5. Private dermatology practice, Toulouse, France;6. Dermatopathology Laboratory, Dermatology Clinic, Strasbourg University Hospital, Strasbourg, France;7. EA1379 EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques–Dermatological Epidemiology and Therapeutic Evaluation), Dermatology Department, Paris-Est University, Henri Mondor Hospital, Créteil, AP–HP, Créteil, France;1. Service de dermatologie, hospices civils de Lyon, centre hospitalier Lyon-Sud, 69495 Pierre-Bénite cedex, France;2. Hospices civils de Lyon, groupement hospitalier Est, centre régional de traitement de l’Hémophilie, 69500 Bron cedex, France;3. Pharmacovigilance, hospices civils de Lyon, centre hospitalier Lyon Sud, 69495 Pierre-Bénite cedex, France;4. Service de maladies infectieuses et tropicales, hospices civils de Lyon, hôpital de la Croix Rousse, 69004 Lyon, France;5. Biologie médicale, centre hospitalier de Rouen, hôpital Charles-Nicole, 76031 Rouen cedex, France;6. Service d’anatomopathologie, hospices civils de Lyon, centre hospitalier Lyon Sud, 69495 Pierre-Bénite cedex, France;1. Department of oral surgery, Pellegrin university hospital, Bordeaux, France;2. Paris Salpêtrière university hospital, AP–HP, Paris, France;3. Massilien facial center, Marseille, France;1. Dermatology Department, Saint-Louis Hospital, Paris, France;2. Pathology Department, Saint-Louis Hospital, Paris, France;1. Service de dermatologie, centre hospitalier de Dunkerque, avenue Louis-Herbeaux, 59240 Dunkerque, France;2. Laboratoire d’immunologie, centre hospitalo-universitaire de Rouen, Rouen, France;1. Dermatology department, Cochin hospital, Paris public hospitals, Paris, France;2. Pathology department, Cochin hospital, Paris public hospitals, Paris, France;3. Dermatology department, CISSS de Chaudière-Appalaches-Hôtel-Dieu de Lévis, Lévis, QC, Canada;4. Private medical practice, 4, rue Léon-Delhomme, 75015 Paris, France |
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| Abstract: | IntroductionSince surgery is the first-line treatment for basal cell carcinomas (BCC), the histological aggressiveness of the disease must be clinically predicted in order to apply optimal safety margins that ensure a high rate of complete resection while minimising the risk of recurrence.ObjectivesTo evaluate clinical predictive factors of histological aggressiveness of BCC, we conducted a national prospective multi-centre study.MethodsAll consecutive patients presenting for BCC surgery were included, and standardised clinical data collected, and slides were submitted for review. Trabecular, micronodular and morpheaform BCCs were classified as aggressive.ResultsOf the 2710 cases included, 2274 were histologically confirmed. Clinical subtyping was correct in 49.9% of superficial BCCs, 86.2% of nodular BCCs and only 22% of aggressive BCCs. By multivariate analysis, aggressive BCCs were more frequently ulcerated (45%), indurated (70%), showed adherence (8.6%), and were associated with high-risk anatomical zones (50.3%, P < 0.0001). These predictive clinical features may be helpful for decision making. |
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| Keywords: | Basal cell carcinoma Dermatological surgery Histological subtype Skin cancer Dermatopathology |
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