Swiss Recommendations for Cutaneous Basal Cell Carcinoma

Area of Science:

• Dermatology and Oncology
• Skin Cancer Research

Background:

• Basal cell carcinoma (BCC) is the most prevalent nonmelanoma skin cancer globally and in Switzerland.
• While most BCCs are curable, some present as locally destructive or metastatic tumors requiring specialized treatment.
• Lesion subtype and risk stratification are crucial for effective management decisions.

Framework:

• Development of the first Swiss recommendations for BCC diagnosis and management.
• Based on extensive literature review and expert consensus from dermatologists and oncologists.
• Classification of BCC into low-risk (easy-to-treat) and high-risk (difficult-to-treat) categories based on recurrence risk.

Implementation:

• Recommends a multidisciplinary team approach for BCC management.
• Surgical excision, topical therapies, and radiotherapy are primary treatments for most subtypes and risk levels.
• Nonsurgical alternatives are available for low-risk, superficial tumors unsuitable for surgery.

Implications:

• Systemic therapy, including hedgehog pathway inhibitors (HHIs), is reserved for high-risk BCCs unresponsive to surgery or radiotherapy.
• Emerging therapies like immune checkpoint inhibitors show promise in clinical trials.
• These evidence-based guidelines aim to optimize BCC treatment strategies in Switzerland.