Dermatologic surgery
Treatment of basal cell carcinoma with curettage alone

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Background

Although curettage and electrodesiccation (C&E) is widely used to treat basal cell carcinoma, whether electrodesiccation improves outcome is unknown.

Objective

We sought to compare cure rates of curettage alone with those of C&E.

Methods

We conducted a retrospective records review of patients treated with curettage alone at 5-year follow-up or longer that extracted data about tumor location, size, histologic subtype, biopsy specimen margin involvement, and recurrence, as well as data about the medical history of patients treated in a dermatology clinic in a tertiary-care academic medical institution.

Results

Biopsy-proven tumors (302) amenable to treatment with C&E and treated by a single investigator with curettage alone had a 5-year cure rate of 96.03%, with minimal complications (hypopigmentation, scarring). Tumors involving more than 50% of the deep edge of the shave biopsy specimen had an increased risk of recurrence.

Limitations

This is a retrospective study based on historic controls.

Conclusion

For nonaggressive basal cell carcinoma, curettage alone has a cure rate similar to the published rates for C&E.

Section snippets

Methods

The records of all patients with biopsy-proven BCC clinically amenable to curettage alone who were treated by a single physician (M. J. Z.) at our institution between August 1993 and October 1998 were identified and reviewed retrospectively. Data on patient demographics, tumor characteristics, and potential medical risk factors for BCC were extracted from medical records. All tumors with at least 5-year follow-up were included. The 5-year cure rate was compared with published cure rates for BCC

Results

The retrospective records review identified 136 patients (49 women and 87 men) with 302 tumors. In all, 58 patients (43%) had more than one tumor and 28 patients (21%) had more than two tumors. As shown in Table II, the mean age was 70.7 years, and the mean clinical follow-up was 6.44 years. The mean tumor diameter was 0.69 cm (SD, 0.38; range, 0.1-2.5 cm), for a mean tumor area of 0.61 cm2. Patient age and sex (Table II) and tumor size were not associated with recurrence. A small percentage of

Discussion

In this retrospective study, the 5-year cure rate of 96.03% for the 302 tumors treated by curettage alone is comparable with published cure rates for C&E. Although a prospective study would be ideal, our strict 5-year cure rate is almost identical to the 95.3% rate McDaniel2 reported in a life-table analysis of 644 tumors treated by curettage alone. Because life-table analysis compensates for the bias of patients lost to follow-up, it is considered the most accurate predictor of the actual rate

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  • Drs Zalla and Kyle are currently in private practice in Florence, Ky, and Torrance, Calif, respectively.

    Funding sources: None.

    Conflicts of interest: None identified.

    Reprints not available from the authors.

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