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Metastatic basal cell carcinoma: Prognosis dependent on anatomic site and spread of disease


McCusker, Margaret; Basset-Seguin, Nicole; Dummer, Reinhard; Lewis, Karl; Schadendorf, Dirk; Sekulic, Aleksandar; Hou, Jeannie; Wang, Lisa; Yue, Huibin; Hauschild, Axel (2014). Metastatic basal cell carcinoma: Prognosis dependent on anatomic site and spread of disease. European Journal of Cancer, 50(4):774-783.

Abstract

PURPOSE: This review provides a description of the epidemiology and survival outcomes for cases with metastatic basal cell carcinoma (mBCC) based on published reports (1981-2011).

METHODS: A literature search (MEDLINE via PubMed) was conducted for mBCC case reports published in English: 1981-2011. There were 172 cases that met the following criteria: primary BCC located on skin, metastasis confirmed by pathology and metastasis not resulting from direct tumour spread. From these, 100 mBCC cases with explicit information on follow-up time were selected for analysis. Survival analysis was conducted using Kaplan-Meier methods.

RESULTS: Among 100 mBCC cases selected for analysis, including one case with Gorlin syndrome, 50% had regional metastases (RM) and 50% had distant metastases (DM). Cases with DM were younger at mBCC diagnosis (mean age, 58.0 versus 66.3years for RM; P=0.0013). Among 93 (of 100) cases with treatment information for metastatic disease, more DM cases received chemotherapy (36.2% versus 6.5% for RM), but more RM cases underwent surgery (87.0% versus 40.4% for DM). Among all 100 cases, median survival after mBCC diagnosis was 54months (95% confidence interval (CI), 24-72), with shorter survival in DM (24months; 95% CI, 12-35) versus RM cases (87months; 95% CI, 63-not evaluable).

CONCLUSION: Cases with RM and DM mBCC may have different clinical courses and outcomes. Based on published reports, DM cases were younger at mBCC diagnosis, with shorter median survival than RM cases. This study provides a historical context for emerging mBCC treatments.

Abstract

PURPOSE: This review provides a description of the epidemiology and survival outcomes for cases with metastatic basal cell carcinoma (mBCC) based on published reports (1981-2011).

METHODS: A literature search (MEDLINE via PubMed) was conducted for mBCC case reports published in English: 1981-2011. There were 172 cases that met the following criteria: primary BCC located on skin, metastasis confirmed by pathology and metastasis not resulting from direct tumour spread. From these, 100 mBCC cases with explicit information on follow-up time were selected for analysis. Survival analysis was conducted using Kaplan-Meier methods.

RESULTS: Among 100 mBCC cases selected for analysis, including one case with Gorlin syndrome, 50% had regional metastases (RM) and 50% had distant metastases (DM). Cases with DM were younger at mBCC diagnosis (mean age, 58.0 versus 66.3years for RM; P=0.0013). Among 93 (of 100) cases with treatment information for metastatic disease, more DM cases received chemotherapy (36.2% versus 6.5% for RM), but more RM cases underwent surgery (87.0% versus 40.4% for DM). Among all 100 cases, median survival after mBCC diagnosis was 54months (95% confidence interval (CI), 24-72), with shorter survival in DM (24months; 95% CI, 12-35) versus RM cases (87months; 95% CI, 63-not evaluable).

CONCLUSION: Cases with RM and DM mBCC may have different clinical courses and outcomes. Based on published reports, DM cases were younger at mBCC diagnosis, with shorter median survival than RM cases. This study provides a historical context for emerging mBCC treatments.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Date:2014
Deposited On:07 Mar 2014 16:56
Last Modified:05 Apr 2016 17:42
Publisher:Elsevier
ISSN:0959-8049
Publisher DOI:https://doi.org/10.1016/j.ejca.2013.12.013
PubMed ID:24412051

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