Head and Neck Basal Cell Carcinoma Treatment. Summary of the Doctoral Thesis

Abstract

Basal cell carcinoma (BCC) is the most common skin cancer in Latvia – around 80% of all skin tumours. The main characteristics of BCC is frequent recurrence, long development period, localization in such crucial parts as forehead, cheeks, nose, lips, eyelid, ear, scalp and neck (up to 90%). There are several treatment methods nowadays; however none of the methods can guarantee very efficient treatment (with no recurrence). Aim of the study is to evaluate the long-term efficiency and limitations of surgery, radiotherapy, laser and cryosurgery for the head and neck basal cell carcinoma treatment with respect to clinical and histological types, exact anatomic localization and size, as well as compare different treatment method efficiency taking into account cosmetic results. Research consists of two parts: first part includes analysis of recurrence rate, which includes 968 patients with T1-T2N0M0 morphologically verified primary basal cell carcinoma, which were treated in Latvian Oncology Centre from January 1, 2000 until December 31, 2005. Second part includes analysis of cosmetic results on 842 patients who did not have recurrence in the follow-up period over 5 years after treatment was applied. During the study it was concluded that for particular histological type, size and exact anatomical localization head and neck BCC such alternative treatment methods as radiotherapy, laser and cryosurgery are as efficient as traditional treatment method – operation. Several limitations of each treatment method were revealed during the study: for radiotherapy – infiltrative type, laser – infiltrative type, tumour larger than 20 mm and localization on lip and ear. In case of head and neck BCC cryosurgery can be used in least cases. Overall experts evaluated skin cosmetic result after laser and operation as optimal, as opposed to cryosurgery and radiotherapy. A new unified clinical template for patients with head and neck basal cell carcinoma was developed. A new treatment algorithm for patients with head and neck basal cell carcinoma was developed.