Department of Dermatology, Rouen University Hospital, Rouen, France.
Inserm U905 Pathophysiology and Biotherapy of Inflammatory and Autoimmune Diseases, Institute for Research and Innovation in Biomedicine, Rouen University, University of Normandy, Rouen, France.
J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1291-6. doi: 10.1111/jdv.12798. Epub 2014 Oct 29.
Surgical treatment of basal cell carcinoma (BCC) can be technically difficult in mid-face area. Cryosurgery is proposed for low-risk BCC. Cryosurgery has been poorly investigated in mid-face BCC, which is considered as having a high risk of recurrence.
To assess the results of cryosurgery and curettage-cryosurgery in patients with mid-face BCC.
A retrospective study was performed between 2005 and 2012 in a reference centre for cryosurgery. Inclusion criteria were: (i) diagnosis of BCC confirmed histologically; (ii) location in the mid-face area; (iii) treatment with cryosurgery performed between August 2005 and December 2010; and (iv) minimal follow-up of 18 months after cryosurgery. Follow-up data were recorded until April 2012. Curettage was performed before cryosurgery in 55 cases of nodular BCC (38%). Patients were followed after cryosurgery either by a dermatologist (n = 48) or by their general practitioner (n = 90). Twelve patients were lost to follow-up.
One hundred and thirty-eight patients of mean age 76.5 ± 11.1 years, with a total of 144 BCCs were included. Mean follow-up was 40.7 ± 15.6 months. Wound healing occurred after a median delay of 4 weeks (range 1-12 weeks). No severe complications were recorded. Seven recurrences (4.9%) were observed after a median time of 24 months (range 4-36 months). The 5-year Kaplan-Meier recurrence-free rate was 94%. Thirteen patients with previously treated BCC or morpheiform BCC were treated with cryosurgery as palliative indication, although their subtypes of BCC were theoretical contraindications to cryosurgery. When excluding this subgroup, the 5-year Kaplan-Meier recurrence-free rate of the rest of the population was 96.5%.
Cryosurgery and curettage-cryosurgery can be considered as an alternative and simple method for treatment of BCC of the mid-face area.
基底细胞癌（BCC）的手术治疗在中面部区域可能具有一定难度。冷冻疗法被提议用于低风险的 BCC。然而，冷冻疗法在中面部 BCC 中的应用研究较少，因为中面部 BCC 被认为具有较高的复发风险。
评估冷冻疗法和刮除-冷冻疗法在中面部 BCC 患者中的治疗效果。
这是一项在冷冻治疗参考中心进行的回顾性研究，研究时间为 2005 年至 2012 年。纳入标准为：（i）组织学确诊为 BCC；（ii）位于中面部区域；（iii）在 2005 年 8 月至 2010 年 12 月期间接受冷冻治疗；（iv）冷冻治疗后至少随访 18 个月。随访数据记录至 2012 年 4 月。在 55 例结节性 BCC（38%）中，在冷冻治疗前进行了刮除术。在冷冻治疗后，48 例患者由皮肤科医生进行随访，90 例患者由全科医生进行随访。12 例患者失访。
138 例患者的平均年龄为 76.5±11.1 岁，共 144 个 BCC。平均随访时间为 40.7±15.6 个月。中位愈合时间为 4 周（范围 1-12 周）。未发生严重并发症。7 例（4.9%）患者在中位随访时间 24 个月（范围 4-36 个月）后复发。5 年 Kaplan-Meier 无复发生存率为 94%。13 例先前接受过治疗的 BCC 或形态学 BCC 的患者，由于其 BCC 亚型被认为是冷冻治疗的理论禁忌证，故采用冷冻疗法作为姑息治疗。当排除这一亚组后，其余患者的 5 年 Kaplan-Meier 无复发生存率为 96.5%。
冷冻疗法和刮除-冷冻疗法可被视为中面部 BCC 的一种替代且简单的治疗方法。
