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Surgery Alone (Without Adjuvant Radiation) Adequately Treats Histologic Perineural Basal Cell Carcinomas: A
Mark M Ash1, Frank A Lacy1, Jigar Patel2
1University of North Carolina-Chapel Hill, Department of Dermatology, Chapel Hill, North Carolina.
Summary
Treatment for basal cell carcinoma with perineural invasion shows high survival rates with surgery alone or with radiation. Adjuvant radiation therapy is not recommended if clear margins are achieved post-surgery.
Area of Science:
- Dermatology
- Surgical Oncology
- Evidence-Based Medicine
Background:
- Histologic perineural invasion (PNI) in basal cell carcinoma (BCC) lacks established treatment guidelines.
- This study addresses the need for evidence-based recommendations for managing PNI in BCC.
Approach:
- A systematic review and meta-analysis of 13 cohort studies were conducted.
- Data from 713 patients with PNI in BCC were analyzed, comparing surgical treatments with and without adjuvant radiation therapy.
Key Points:
- Both surgery alone and surgery with adjuvant radiation therapy (Surg + RT) demonstrated high 5-year local control (97.2%) and cancer-specific survival (99.6%).
- No statistically significant differences were observed in recurrence, local control, or cancer-specific survival between surgery alone and Surg + RT groups.
- Limitations include the absence of randomized controlled trials and occasional missing outcome data.
Conclusions:
- Surgery alone and surgery with adjuvant radiation therapy yield equivalent outcomes for basal cell carcinoma with histologic perineural invasion.
- Adjuvant radiation therapy is not recommended for PNI in BCC when clear surgical margins are achieved.
