Materiały źródłowe

• #1 Risk Factors and Innovations in Risk Assessment for Melanoma, Basal Cell Carcinoma, and Squamous Cell Carcinoma

  https://www.mdpi.com/2072-6694/16/5/1016

  Basal cell carcinoma (BCC) is the most common skin cancer worldwide, accounting for over 85% of all NMSCs in Europe. There are several risk factors that are associated with BCC and, as for melanoma, the development of BCC is an interplay of extrinsic and intrinsic risk factors. […] Exposure to solar UV radiation is the major external risk factor for the development of BCC. In Australia, for example, it is assumed that nearly all BCCs are attributable to high UV exposure. Both, intermittent and chronic sun exposure increase the risk for BCC. Intermittent sun exposure is associated with a 2.1 increased odds for BCC. Sunburn often serves as a measure of intermittent sunlight exposure, and it is another, independent, extrinsic risk factor for BCC. Experiencing any sunburn during childhood or later in life is associated with a higher odds. A dose-dependent effect is observed: the risk of developing BCC doubles every 5 sunburns, regardless of whether they are experienced in childhood or later in life.

• #2 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #3 Survival statistics for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival/survival-statistics

  Survival statistics for cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, a 5-year relative survival statistic is estimated for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are the most common types of non-melanoma skin cancer. […] Survival for most non-melanoma skin cancers is excellent. The 5-year relative survival for BCC is 100%. This means that, on average, all of the people diagnosed with BCC are just as likely to live at least 5 years after their diagnosis as people in the general population. […] Non-melanoma skin cancer is often found and treated early, so the prognosis is very good. […] BCC, the most common type of skin cancer, rarely spreads to other parts of the body. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #4 Prognosis and survival for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] Prognosis and survival for most non-melanoma skin cancers is excellent. […] Doctors use many of the following prognostic factors to classify basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) into risk groups. The risk groups help the doctor estimate the risk that the cancer will come back (recur). […] The subtypes of BCC that have a less favourable prognosis include infiltrative, micronodular and morpheaform. The subtypes of BCC that have a better prognosis are nodular and superficial. […] Low-grade non-melanoma skin cancers have a better prognosis than high-grade cancers.

• #5 Prognosis and survival for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] Prognosis and survival for most non-melanoma skin cancers is excellent. […] Doctors use many of the following prognostic factors to classify basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) into risk groups. The risk groups help the doctor estimate the risk that the cancer will come back (recur). […] The subtypes of BCC that have a less favourable prognosis include infiltrative, micronodular and morpheaform. The subtypes of BCC that have a better prognosis are nodular and superficial. […] Low-grade non-melanoma skin cancers have a better prognosis than high-grade cancers.

• #6 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #7 Prognosis and survival for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival

  A prognosis is the doctor’s best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors. […] Prognosis and survival for most non-melanoma skin cancers is excellent. […] Doctors use many of the following prognostic factors to classify basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) into risk groups. The risk groups help the doctor estimate the risk that the cancer will come back (recur). […] The subtypes of BCC that have a less favourable prognosis include infiltrative, micronodular and morpheaform. The subtypes of BCC that have a better prognosis are nodular and superficial. […] Low-grade non-melanoma skin cancers have a better prognosis than high-grade cancers.

• #8 Prognosis and survival for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival

  Non-melanoma skin cancer that has grown into or around nerves (called perineural invasion) has a less favourable prognosis. […] People with non-melanoma skin cancer and a weakened immune system have a poorer prognosis than people without a weakened immune system. […] Non-melanoma skin cancer that has grown deeper into the skin or has spread to nearby tissues and structures has a less favourable prognosis. Non-melanoma skin cancer that has spread to farther parts of the body (called distant metastases) has a very poor prognosis.

• #9 Prognosis and survival for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival

  Non-melanoma skin cancer that has grown into or around nerves (called perineural invasion) has a less favourable prognosis. […] People with non-melanoma skin cancer and a weakened immune system have a poorer prognosis than people without a weakened immune system. […] Non-melanoma skin cancer that has grown deeper into the skin or has spread to nearby tissues and structures has a less favourable prognosis. Non-melanoma skin cancer that has spread to farther parts of the body (called distant metastases) has a very poor prognosis.

• #10 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Basal-Cell-Carcinoma-Prognosis.aspx

  Basal cell carcinoma is one of the most common skin cancers in America and Australia and incidence is also on the rise in the UK. […] If basal cell cancer is treated in a timely and appropriate manner, full recovery is likely. […] Sometimes, carcinomas reoccur after being successfully treated and removed for the first time but this is less likely in the case of smaller lesions. […] Tumors can be categorized according to certain prognostic factors that influence patient outcomes. […] Large and more deep-rooted lesions have a worse prognosis than small and superficial lesions. […] Tumors with a diffuse margin are usually less responsive to treatment than those with more clear-cut margins. […] The presence of more rapidly growing tumors and multiple tumors increases the risk of a poor treatment outcome. […] Recurrent tumors and failure of initial therapy signifies a less positive patient outcome. […] Suppressed immunity due to the use of immunosuppressants after organ transplant or to treat HIV for example, can lead to a poorer treatment outcome.

• #11 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #12 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Basal-Cell-Carcinoma-Prognosis.aspx

  Basal cell carcinoma is one of the most common skin cancers in America and Australia and incidence is also on the rise in the UK. […] If basal cell cancer is treated in a timely and appropriate manner, full recovery is likely. […] Sometimes, carcinomas reoccur after being successfully treated and removed for the first time but this is less likely in the case of smaller lesions. […] Tumors can be categorized according to certain prognostic factors that influence patient outcomes. […] Large and more deep-rooted lesions have a worse prognosis than small and superficial lesions. […] Tumors with a diffuse margin are usually less responsive to treatment than those with more clear-cut margins. […] The presence of more rapidly growing tumors and multiple tumors increases the risk of a poor treatment outcome. […] Recurrent tumors and failure of initial therapy signifies a less positive patient outcome. […] Suppressed immunity due to the use of immunosuppressants after organ transplant or to treat HIV for example, can lead to a poorer treatment outcome.

• #13 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Basal-Cell-Carcinoma-Prognosis.aspx

  Basal cell carcinoma is one of the most common skin cancers in America and Australia and incidence is also on the rise in the UK. […] If basal cell cancer is treated in a timely and appropriate manner, full recovery is likely. […] Sometimes, carcinomas reoccur after being successfully treated and removed for the first time but this is less likely in the case of smaller lesions. […] Tumors can be categorized according to certain prognostic factors that influence patient outcomes. […] Large and more deep-rooted lesions have a worse prognosis than small and superficial lesions. […] Tumors with a diffuse margin are usually less responsive to treatment than those with more clear-cut margins. […] The presence of more rapidly growing tumors and multiple tumors increases the risk of a poor treatment outcome. […] Recurrent tumors and failure of initial therapy signifies a less positive patient outcome. […] Suppressed immunity due to the use of immunosuppressants after organ transplant or to treat HIV for example, can lead to a poorer treatment outcome.

• #14 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  Anatomic location of BCC also plays a factor in rate of recurrence, with BCC lesions located on the head and neck (eg, face or ear, the H zone, or mask area) associated with more aggressive tumor behavior and a higher recurrence rate than those in other locations (eg, trunk and extremities). […] The panelists concluded that although the data are promising on HH inhibitors and checkpoint inhibitor therapy, more treatment options, such as intralesional therapies, oncolytic viruses, and therapeutic combinations and sequences, will be important to accommodate the high heterogeneity among patients with laBCC or mBCC.

• #15 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #16 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #17 Basal Cell Carcinoma: Symptoms, Causes, and Treatment

  https://patient.info/doctor/basal-cell-carcinoma

  Mortality is low because basal cell carcinomas rarely metastasise. […] Recurrent tumours have poorer cure rates than primary tumours. […] Following development of a BCC, patients are at significantly increased risk of developing subsequent BCCs at other sites. […] High-risk groups for the development of further BCC include patients with truncal BCC and those presenting with tumour clusters. […] Patients with BCC also have an increased risk of developing SCC and malignant melanoma. […] There may also be a small increased risk of other malignancies, such as cancer of the lung, thyroid, mouth, breast and cervix and also non-Hodgkin’s lymphoma.

• #18 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #19 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  Although basal cell carcinoma generally has a good prognosis, improving tolerance to targeted Hedgehog inhibitors and optimizing second-line treatment with immune checkpoint inhibitors are important for the small subset of patients who develop locally advanced or metastatic disease. […] Most cases of BCC have a very favorable prognosis and a high cure rate. […] BCC that is metastatic at diagnosis is extremely rare. […] Estimates currently cited in the literature for the incidence of metastatic BCC (mBCC) rely on studies dating back to the 1970s and 1980s, and most authors cite an incidence for mBCC of less than 0.1%, with other authors citing a range from 0.0028% to 0.55%. […] Although most cases of nonmetastatic BCC are completely curable, mBCC has historically been associated with a very poor prognosis and few treatment options.

• #20 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #21 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  Although basal cell carcinoma generally has a good prognosis, improving tolerance to targeted Hedgehog inhibitors and optimizing second-line treatment with immune checkpoint inhibitors are important for the small subset of patients who develop locally advanced or metastatic disease. […] Most cases of BCC have a very favorable prognosis and a high cure rate. […] BCC that is metastatic at diagnosis is extremely rare. […] Estimates currently cited in the literature for the incidence of metastatic BCC (mBCC) rely on studies dating back to the 1970s and 1980s, and most authors cite an incidence for mBCC of less than 0.1%, with other authors citing a range from 0.0028% to 0.55%. […] Although most cases of nonmetastatic BCC are completely curable, mBCC has historically been associated with a very poor prognosis and few treatment options.

• #22 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  Although basal cell carcinoma generally has a good prognosis, improving tolerance to targeted Hedgehog inhibitors and optimizing second-line treatment with immune checkpoint inhibitors are important for the small subset of patients who develop locally advanced or metastatic disease. […] Most cases of BCC have a very favorable prognosis and a high cure rate. […] BCC that is metastatic at diagnosis is extremely rare. […] Estimates currently cited in the literature for the incidence of metastatic BCC (mBCC) rely on studies dating back to the 1970s and 1980s, and most authors cite an incidence for mBCC of less than 0.1%, with other authors citing a range from 0.0028% to 0.55%. […] Although most cases of nonmetastatic BCC are completely curable, mBCC has historically been associated with a very poor prognosis and few treatment options.

• #23 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #24 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #25 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #26 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #27 Risk Factors and Innovations in Risk Assessment for Melanoma, Basal Cell Carcinoma, and Squamous Cell Carcinoma

  https://www.mdpi.com/2072-6694/16/5/1016

  A significant association between BCC and diseases related to iatrogenic or non-iatrogenic immunosuppression has been observed, for example in the context of organ transplantation or autoimmune diseases. In comparison with the general population, the relative risk of BCC is increased sixfold in OTRs. The risk is higher in kidney and heart/lung recipients compared with liver recipients, and it increases over time since transplantation. […] Previous NMSC increases the risk of developing BCC. The 3-year cumulative risk for developing a subsequent BCC after the first one varies between studies, with a mean of 44%. This represents an at least 10-fold increase in incidence compared with the rate in a comparable general population. The risk of developing BCC in patients with a prior cutaneous squamous cell carcinoma (cSCC) is approximately equal to the risk observed among individuals with a prior BCC.

• #28 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #29 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  Most reports show that the distance to the closest resection margin is an important predictor of recurrence. […] Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of developing a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. […] Histologic types of BCC at higher risk for recurrence include morpheaform (sclerotic), micronodular, infiltrative, and superficial (multicentric). Higher recurrence rates are also seen with the following: recurrent tumors that have been treated previously, large tumors (≥2 cm), deeply infiltrating tumors.

• #30 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  The reported prevalence of BCC having an aggressive histology ranges from 2.5% to 44% in large studies of referral centers. […] Given a patients constellation of clinical and pathological risk factors, the risk of recurrence forms the basis of treatment selection. […] For patients with high-risk tumors (ie, having 1 of the aforementioned risk factors for recurrence), the NCCN guidelines recommend any of the following primary treatment options: (1) Mohs micrographic surgery (MMS), (2) excision with complete circumferential peripheral and deep margin assessment with permanent section analysis or intraoperative frozen section analysis, or (3) standard excision with wider surgical margins than what is used for low-risk disease and postoperative margin assessment with linear or delayed repair.

• #31 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  The reported prevalence of BCC having an aggressive histology ranges from 2.5% to 44% in large studies of referral centers. […] Given a patients constellation of clinical and pathological risk factors, the risk of recurrence forms the basis of treatment selection. […] For patients with high-risk tumors (ie, having 1 of the aforementioned risk factors for recurrence), the NCCN guidelines recommend any of the following primary treatment options: (1) Mohs micrographic surgery (MMS), (2) excision with complete circumferential peripheral and deep margin assessment with permanent section analysis or intraoperative frozen section analysis, or (3) standard excision with wider surgical margins than what is used for low-risk disease and postoperative margin assessment with linear or delayed repair.

• #32 Basal Cell Carcinoma: Symptoms, Causes, and Treatment

  https://patient.info/doctor/basal-cell-carcinoma

  Mortality is low because basal cell carcinomas rarely metastasise. […] Recurrent tumours have poorer cure rates than primary tumours. […] Following development of a BCC, patients are at significantly increased risk of developing subsequent BCCs at other sites. […] High-risk groups for the development of further BCC include patients with truncal BCC and those presenting with tumour clusters. […] Patients with BCC also have an increased risk of developing SCC and malignant melanoma. […] There may also be a small increased risk of other malignancies, such as cancer of the lung, thyroid, mouth, breast and cervix and also non-Hodgkin’s lymphoma.

• #33 Basal Cell Carcinoma: Symptoms, Causes, and Treatment

  https://patient.info/doctor/basal-cell-carcinoma

  Mortality is low because basal cell carcinomas rarely metastasise. […] Recurrent tumours have poorer cure rates than primary tumours. […] Following development of a BCC, patients are at significantly increased risk of developing subsequent BCCs at other sites. […] High-risk groups for the development of further BCC include patients with truncal BCC and those presenting with tumour clusters. […] Patients with BCC also have an increased risk of developing SCC and malignant melanoma. […] There may also be a small increased risk of other malignancies, such as cancer of the lung, thyroid, mouth, breast and cervix and also non-Hodgkin’s lymphoma.

• #34 Basal Cell Carcinoma: Symptoms, Causes, and Treatment

  https://patient.info/doctor/basal-cell-carcinoma

  Mortality is low because basal cell carcinomas rarely metastasise. […] Recurrent tumours have poorer cure rates than primary tumours. […] Following development of a BCC, patients are at significantly increased risk of developing subsequent BCCs at other sites. […] High-risk groups for the development of further BCC include patients with truncal BCC and those presenting with tumour clusters. […] Patients with BCC also have an increased risk of developing SCC and malignant melanoma. […] There may also be a small increased risk of other malignancies, such as cancer of the lung, thyroid, mouth, breast and cervix and also non-Hodgkin’s lymphoma.

• #35 Basal Cell Carcinoma: Symptoms, Causes, and Treatment

  https://patient.info/doctor/basal-cell-carcinoma

  Mortality is low because basal cell carcinomas rarely metastasise. […] Recurrent tumours have poorer cure rates than primary tumours. […] Following development of a BCC, patients are at significantly increased risk of developing subsequent BCCs at other sites. […] High-risk groups for the development of further BCC include patients with truncal BCC and those presenting with tumour clusters. […] Patients with BCC also have an increased risk of developing SCC and malignant melanoma. […] There may also be a small increased risk of other malignancies, such as cancer of the lung, thyroid, mouth, breast and cervix and also non-Hodgkin’s lymphoma.

• #36 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  The reported prevalence of BCC having an aggressive histology ranges from 2.5% to 44% in large studies of referral centers. […] Given a patients constellation of clinical and pathological risk factors, the risk of recurrence forms the basis of treatment selection. […] For patients with high-risk tumors (ie, having 1 of the aforementioned risk factors for recurrence), the NCCN guidelines recommend any of the following primary treatment options: (1) Mohs micrographic surgery (MMS), (2) excision with complete circumferential peripheral and deep margin assessment with permanent section analysis or intraoperative frozen section analysis, or (3) standard excision with wider surgical margins than what is used for low-risk disease and postoperative margin assessment with linear or delayed repair.

• #37 Analysis of residual disease in periocular basal cell carcinoma following hedgehog pathway inhibition: Follow up to the VISORB trial | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265212

  While vismodegib has a relatively high response rate, unfortunately a subset of these tumors become resistant and recur. In a recent study of advanced BCC, 21% of patients who initially responded acquired resistance with a median regrowth time of 56 weeks. Although many BCCs can be cured via excision, recurrence rates are high for advanced orbital and periocular BCC (opBCC), and excision may cause loss of visual function. […] 100% of patients achieved a successful visual function outcome, as measured by a Visual Assessment Weighted Score (VAWS). 56% of patients achieved a complete clinical response to vismodegib, and of patients who elected to undergo excision post-treatment, 67% had no evidence of residual disease in excision samples. […] While conventional histology is adequate for margin control of vismodegib-nave tumors, our results suggest that this method can miss residual and potentially resistant cells. Understanding the mutational status of an advanced BCC tumor provides insight into the best course of treatment for patients.

• #38 Analysis of residual disease in periocular basal cell carcinoma following hedgehog pathway inhibition: Follow up to the VISORB trial | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265212

  While vismodegib has a relatively high response rate, unfortunately a subset of these tumors become resistant and recur. In a recent study of advanced BCC, 21% of patients who initially responded acquired resistance with a median regrowth time of 56 weeks. Although many BCCs can be cured via excision, recurrence rates are high for advanced orbital and periocular BCC (opBCC), and excision may cause loss of visual function. […] 100% of patients achieved a successful visual function outcome, as measured by a Visual Assessment Weighted Score (VAWS). 56% of patients achieved a complete clinical response to vismodegib, and of patients who elected to undergo excision post-treatment, 67% had no evidence of residual disease in excision samples. […] While conventional histology is adequate for margin control of vismodegib-nave tumors, our results suggest that this method can miss residual and potentially resistant cells. Understanding the mutational status of an advanced BCC tumor provides insight into the best course of treatment for patients.

• #39 Analysis of residual disease in periocular basal cell carcinoma following hedgehog pathway inhibition: Follow up to the VISORB trial | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265212

  While vismodegib has a relatively high response rate, unfortunately a subset of these tumors become resistant and recur. In a recent study of advanced BCC, 21% of patients who initially responded acquired resistance with a median regrowth time of 56 weeks. Although many BCCs can be cured via excision, recurrence rates are high for advanced orbital and periocular BCC (opBCC), and excision may cause loss of visual function. […] 100% of patients achieved a successful visual function outcome, as measured by a Visual Assessment Weighted Score (VAWS). 56% of patients achieved a complete clinical response to vismodegib, and of patients who elected to undergo excision post-treatment, 67% had no evidence of residual disease in excision samples. […] While conventional histology is adequate for margin control of vismodegib-nave tumors, our results suggest that this method can miss residual and potentially resistant cells. Understanding the mutational status of an advanced BCC tumor provides insight into the best course of treatment for patients.

• #40 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #41 Analysis of residual disease in periocular basal cell carcinoma following hedgehog pathway inhibition: Follow up to the VISORB trial | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265212

  The data we have gathered from the VISORB clinical trial and this associated study provide new insight into how opBCC tumors respond to vismodegib. However, here we provide practice-changing evidence of potentially resistant residual disease in patients displaying complete response. This residual disease is visible in HE stained sections, but more apparent in Keratin 5 and Gli1 in situ stained sections. […] Lastly, while vismodegib is commonly used as a long-term therapy for advanced BCC, our data suggest that its best use may be as a neoadjuvant, maximizing chemoreduction (particularly of deep margins) while minimizing selection of resistant alleles prior to definitive excision in which margins are assessed by more than routine HE staining.

• #42 Analysis of residual disease in periocular basal cell carcinoma following hedgehog pathway inhibition: Follow up to the VISORB trial | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265212

  While vismodegib has a relatively high response rate, unfortunately a subset of these tumors become resistant and recur. In a recent study of advanced BCC, 21% of patients who initially responded acquired resistance with a median regrowth time of 56 weeks. Although many BCCs can be cured via excision, recurrence rates are high for advanced orbital and periocular BCC (opBCC), and excision may cause loss of visual function. […] 100% of patients achieved a successful visual function outcome, as measured by a Visual Assessment Weighted Score (VAWS). 56% of patients achieved a complete clinical response to vismodegib, and of patients who elected to undergo excision post-treatment, 67% had no evidence of residual disease in excision samples. […] While conventional histology is adequate for margin control of vismodegib-nave tumors, our results suggest that this method can miss residual and potentially resistant cells. Understanding the mutational status of an advanced BCC tumor provides insight into the best course of treatment for patients.

• #43 Analysis of residual disease in periocular basal cell carcinoma following hedgehog pathway inhibition: Follow up to the VISORB trial | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265212

  The data we have gathered from the VISORB clinical trial and this associated study provide new insight into how opBCC tumors respond to vismodegib. However, here we provide practice-changing evidence of potentially resistant residual disease in patients displaying complete response. This residual disease is visible in HE stained sections, but more apparent in Keratin 5 and Gli1 in situ stained sections. […] Lastly, while vismodegib is commonly used as a long-term therapy for advanced BCC, our data suggest that its best use may be as a neoadjuvant, maximizing chemoreduction (particularly of deep margins) while minimizing selection of resistant alleles prior to definitive excision in which margins are assessed by more than routine HE staining.

• #44 Survival statistics for non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/prognosis-and-survival/survival-statistics

  Survival statistics for cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In Canada, a 5-year relative survival statistic is estimated for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), which are the most common types of non-melanoma skin cancer. […] Survival for most non-melanoma skin cancers is excellent. The 5-year relative survival for BCC is 100%. This means that, on average, all of the people diagnosed with BCC are just as likely to live at least 5 years after their diagnosis as people in the general population. […] Non-melanoma skin cancer is often found and treated early, so the prognosis is very good. […] BCC, the most common type of skin cancer, rarely spreads to other parts of the body. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #45 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #46 Basal Cell Carcinoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/276624-overview

  The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon. […] Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones. […] Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended. […] The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery.

• #47 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  Although basal cell carcinoma generally has a good prognosis, improving tolerance to targeted Hedgehog inhibitors and optimizing second-line treatment with immune checkpoint inhibitors are important for the small subset of patients who develop locally advanced or metastatic disease. […] Most cases of BCC have a very favorable prognosis and a high cure rate. […] BCC that is metastatic at diagnosis is extremely rare. […] Estimates currently cited in the literature for the incidence of metastatic BCC (mBCC) rely on studies dating back to the 1970s and 1980s, and most authors cite an incidence for mBCC of less than 0.1%, with other authors citing a range from 0.0028% to 0.55%. […] Although most cases of nonmetastatic BCC are completely curable, mBCC has historically been associated with a very poor prognosis and few treatment options.

• #48 Updates and Advances in Basal Cell Carcinoma

  https://www.onclive.com/view/updates-and-advances-in-basal-cell-carcinoma

  Although basal cell carcinoma generally has a good prognosis, improving tolerance to targeted Hedgehog inhibitors and optimizing second-line treatment with immune checkpoint inhibitors are important for the small subset of patients who develop locally advanced or metastatic disease. […] Most cases of BCC have a very favorable prognosis and a high cure rate. […] BCC that is metastatic at diagnosis is extremely rare. […] Estimates currently cited in the literature for the incidence of metastatic BCC (mBCC) rely on studies dating back to the 1970s and 1980s, and most authors cite an incidence for mBCC of less than 0.1%, with other authors citing a range from 0.0028% to 0.55%. […] Although most cases of nonmetastatic BCC are completely curable, mBCC has historically been associated with a very poor prognosis and few treatment options.

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