Bernardeau K, Derancourt C, Cambie M, Salmon-Ehr V, Morel M, Cavenelle F, Léonard F, Kalis B, Bernard P
Service de Dermatologie, CHU Robert-Debré, 51092 Reims Cedex, France.
Ann Dermatol Venereol. 2000 Feb;127(2):175-9.
Cryosurgery is a well-established therapeutic modality for basal cell carcinoma. We report herein an important series of basal cell carcinoma treated by cryosurgery, with a five year cure rate evaluation.
Retrospective study with 395 basal cell carcinomas (over 358 patients - sex ratio H/F: 0.85) treated by cryosurgery between 1981 and 1992. For each patient the data were: age, sex, size of the lesion, location, clinical sub-type, tissue-temperature monitoring, recurrence date and esthetic outcome.
The lesions were located on the face (93 p. 100) and back (7 p. 100). Mean size was 17 mm. Clinical sub-types were known for 178 lesions; 11 p. 100 of BCC were morpheaform. Tissue-temperature monitoring was performed for 55 p. 100 of cases. 111 tumors were observed for more than 5 years. The 5-year actuarial failure rate was 9 p. 100. The 5-year cure rate was not significantly altered by sex, size of lesions, location and clinical sub-type. No frequent recurrences were observed when tissue-temperature monitoring had not been performed. Complications were rare and esthetic outcome was good.
The 5-year actuarial recurrence rate with cryosurgery is similar to conventional surgery. It is not essential to control tissue-temperature for preventing recurrences. Cryosurgery is a reliable treatment and outcome depends on surgeon experience. Quickness and low cost of this procedure argue for choosing cryosurgery when treating elderly patients.
冷冻手术是治疗基底细胞癌的一种成熟的治疗方式。我们在此报告一系列经冷冻手术治疗的基底细胞癌病例，并对其五年治愈率进行评估。
对1981年至1992年间接受冷冻手术治疗的395例基底细胞癌（涉及358例以上患者，男女比例为0.85）进行回顾性研究。对于每位患者，收集的数据包括：年龄、性别、病变大小、位置、临床亚型、组织温度监测、复发日期和美学效果。
病变位于面部（93%）和背部（7%）。平均大小为17毫米。已知178例病变的临床亚型；11%的基底细胞癌为硬斑病样。55%的病例进行了组织温度监测。111个肿瘤观察超过5年。5年精算失败率为9%。5年治愈率不受性别、病变大小、位置和临床亚型的显著影响。未进行组织温度监测时，未观察到频繁复发。并发症罕见，美学效果良好。
冷冻手术的5年精算复发率与传统手术相似。控制组织温度对于预防复发并非必要。冷冻手术是一种可靠的治疗方法，结果取决于外科医生的经验。该手术快速且成本低，这支持在治疗老年患者时选择冷冻手术。
