Anna A J H Zwanenburg, Winan J Van Houdt, A Marjolein Schrijver, Willem H Schreuder, Michel W J M Wouters, Elsemieke I Plasmeijer
{"title":"Clinical Features and Outcomes of Locally Advanced and Metastatic Basal Cell Carcinoma.","authors":"Anna A J H Zwanenburg, Winan J Van Houdt, A Marjolein Schrijver, Willem H Schreuder, Michel W J M Wouters, Elsemieke I Plasmeijer","doi":"10.2340/actadv.v105.43240","DOIUrl":null,"url":null,"abstract":"<p><p>Cutaneous basal cell carcinoma (BCC) is a primarily indolent tumour that is easily cured. However, locally advanced BCC (laBCC) and metastatic BCC can have a poor prognosis. This retrospective cohort study, conducted at a single cancer centre over a 32-year period, reports the characteristics and clinical course of 51 patients with laBCC or metastatic BCC. Thirty-five patients were men (69%), with a mean age of 72 years. Most primary BCCs were located in the head and neck (59%), and were treated with surgery (78%). Thirty-four patients had laBCC; 6 of those developed subsequent metastasis. Twenty-three metastatic BCCs were included. The median size of laBCC was 73 mm (IQR 110; range 15-400 mm), with 71% measuring 5 cm or larger. Tumour infiltration beyond the subcutaneous fat was present in 59% of laBCC and bone infiltration in 12%. Of laBCC, 44% experienced local recurrence after resection, which was seen in 35% of local tumours later developing metastasis. Median time to metastasis was 33 months. Most patients developed nodal metastases only (70%), but 26% developed distant metastases. Fifteen patients died during follow-up (29%). Three patients died of their laBCC with a 5-year disease-specific survival of 79%. Five-year disease-specific survival for metastatic BCC was 30%. Patients with laBCC in this cohort were at high risk of local recurrence and metastasis, and 12% died of their laBCC. These findings highlight the need for intensified follow-up for this relatively rare population, especially since Hedgehog inhibitors and PD1 inhibitors might be available for these patients.</p>","PeriodicalId":6944,"journal":{"name":"Acta dermato-venereologica","volume":"105 ","pages":"adv43240"},"PeriodicalIF":3.7000,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta dermato-venereologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/actadv.v105.43240","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Cutaneous basal cell carcinoma (BCC) is a primarily indolent tumour that is easily cured. However, locally advanced BCC (laBCC) and metastatic BCC can have a poor prognosis. This retrospective cohort study, conducted at a single cancer centre over a 32-year period, reports the characteristics and clinical course of 51 patients with laBCC or metastatic BCC. Thirty-five patients were men (69%), with a mean age of 72 years. Most primary BCCs were located in the head and neck (59%), and were treated with surgery (78%). Thirty-four patients had laBCC; 6 of those developed subsequent metastasis. Twenty-three metastatic BCCs were included. The median size of laBCC was 73 mm (IQR 110; range 15-400 mm), with 71% measuring 5 cm or larger. Tumour infiltration beyond the subcutaneous fat was present in 59% of laBCC and bone infiltration in 12%. Of laBCC, 44% experienced local recurrence after resection, which was seen in 35% of local tumours later developing metastasis. Median time to metastasis was 33 months. Most patients developed nodal metastases only (70%), but 26% developed distant metastases. Fifteen patients died during follow-up (29%). Three patients died of their laBCC with a 5-year disease-specific survival of 79%. Five-year disease-specific survival for metastatic BCC was 30%. Patients with laBCC in this cohort were at high risk of local recurrence and metastasis, and 12% died of their laBCC. These findings highlight the need for intensified follow-up for this relatively rare population, especially since Hedgehog inhibitors and PD1 inhibitors might be available for these patients.
期刊介绍:
Acta Dermato-Venereologica publishes high-quality manuscripts in English in the field of Dermatology and Venereology, dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of Review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs.