European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma - update 2023

Scientific paper - Review paper

• Author: Ketty Peris
• Author: Maria Concetta Fargnoli
• Author: Roland Kaufmann
• Author: Petr Arenberger
• Author: Lars Bastholt
• Author: Nicole Basset Seguin
• Author: Veronique Bataille
• Author: Lieve Brochez
• Author: Veronique del Marmol
• Author: Reinhard Dummer
• Author: Ana-Marie Forsea
• Author: Caroline Gaudy-Marqueste
• Author: Catherine A. Harwood
• Author: Axel Hauschild
• Author: Christoph Höller
• Author: Lidija Kandolf
• Author: Nicole W.J. Kellerners-Smeets
• Author: Aimilios Lallas
• Author: Ulrike Leiter
• Author: Josep Malvehy
• Author: Branka Marinović
• Author: Zeljko Mijuskovic
• Author: David Moreno-Ramirez
• Author: Eduardo Nagore
• Author: Paul Nathan
• Author: Alexander J. Stratigos
• Author: Eggert Stockfleth
• Author: Luca Tagliaferri
• Author: Myrto Trakatelli
• Author: Ricardo Vieira
• Author: Iris Zalaudek
• Author: Claus Garbe
• Author's institution: University of Zagreb; School of Medicine; (Department of Dermatology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract (english)

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.

• Keywords (english): Aged; Carcinoma, Basal Cell / diagnosis; Carcinoma, Basal Cell / therapy; Consensus; Hedgehog Proteins; Humans; Immunotherapy; Skin Neoplasms / diagnosis; Skin Neoplasms / therapy
• Language: english
• Publication type: Scientific paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: European Journal of Cancer
• Numbering: vol. 192, 113254
• p-ISSN: 0959-8049
• DOI: https://doi.org/10.1016/j.ejca.2023.113254
• URN:NBN: urn:nbn:hr:105:040164
• Publication: 2023-10
• Document URL: https://linkinghub.elsevier.com/retrieve/pii/S0959804923003568
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-08-26 08:00:08