Rowe D E, Carroll R J, Day C L
University of Texas Health Science Center, San Antonio.
J Dermatol Surg Oncol. 1989 Apr;15(4):424-31. doi: 10.1111/j.1524-4725.1989.tb03249.x.
We reviewed all studies (since 1945) reporting recurrence rates for treatment of recurrent (previously treated) basal cell carcinomas (BCC) using surgical excision, radiotherapy, cryotherapy, curettage and electrodesiccation, and Mohs micrographic surgery. The 5-year recurrence rate for Mohs micrographic surgery is 5.6%. The recurrence rate for non-Mohs modalities of 19.9% is nearly four times higher. Individual recurrence rates for the non-Mohs modalities are 17.4% for surgical excision, 40.0% for curettage and electrodesiccation, and 9.8% for radiation therapy. There are no studies reporting 5-year data for cryotherapy. However, the recurrence rate is 13.0% for cryotherapy when the follow-up period is less than five years. The data support the following conclusions: (1) Mohs surgery is the treatment of choice for recurrent BCC; (2) if the patient is not a surgical candidate and the lesion is small, radiation therapy is an alternative that offers a better chance for cure than the other non-Mohs modalities; and (3) curettage and electrodesiccation should not be used to treat recurrent basal cell carcinoma.
我们回顾了所有（自1945年以来）报告复发性（先前已接受治疗）基底细胞癌（BCC）采用手术切除、放射治疗、冷冻疗法、刮除术加电干燥法以及莫氏显微外科手术治疗后复发率的研究。莫氏显微外科手术的5年复发率为5.6%。非莫氏手术方式的复发率为19.9%，几乎高出四倍。非莫氏手术方式的个体复发率分别为：手术切除17.4%，刮除术加电干燥法40.0%，放射治疗9.8%。尚无研究报告冷冻疗法的5年数据。然而，当随访期少于五年时，冷冻疗法的复发率为13.0%。这些数据支持以下结论：（1）莫氏手术是复发性基底细胞癌的首选治疗方法；（2）如果患者不适合手术且病变较小，放射治疗是一种替代方法，与其他非莫氏手术方式相比，其治愈机会更大；（3）刮除术加电干燥法不应被用于治疗复发性基底细胞癌。
