Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45100 Ioannina, Greece.
DELC Clinic, 2502 Biel/Bienne, Switzerland.
Curr Oncol. 2022 Nov 7;29(11):8475-8482. doi: 10.3390/curroncol29110668.
In this retrospective, chart review study, we evaluated the feasibility of immunocryosurgery in facial, non-superficial basal cell carcinomas (BCC) that had relapsed after standard surgery. Inclusion criteria were (a) 'biopsy confirmed relapse of facial BCC', (b) known 'calendar year of surgical excision(s)', and (c) 'relapse within 10 years after the last surgical excision'. Tumors treated from 1 January 2011 to 31 December 2020 with a standard 5-week immunocryosurgery cycle (daily imiquimod application for 5 weeks and a cryosurgery session at day 14) were included. Descriptive statistics, Kaplan-Meier method, and Cox proportional hazards model were calculated with significance at < 0.05. From the = 27 BCC evaluated, = 20 (74.1 ± 8.4%) cleared after one immunocryosurgery cycle. Two of the remaining cases cleared completely after a repeat cycle, one patient favored surgery, and four BCC did not clear despite additional immunocryosurgery cycles (feasibility 81.5 ± 7.5%). Of the 22 tumors with clinical outcome 'complete clearance with immunocryosurgery', three BCC relapsed at 9, 28, and 50 months. Overall, the 5-year treatment efficacy rate was 60.2 ± 13.4% (mean follow-up 94.6 ± 15.1 months). In total, 20/27 BCC relapses after surgery (74.1%) were tumor-free at the end of personalized follow-up times (66.7 ± 12.4% tumor free patients at 5-year follow-up). Number of tumor relapses before immunocryosurgery was the single predictor of tumor progression after immunocryosurgery ( = 0.012). Conclusively, immunocryosurgery could be further evaluated as an alternative, definitive treatment of selected facial BCC relapsing after surgery.
在这项回顾性图表审查研究中，我们评估了免疫冷冻疗法在面部非浅表基底细胞癌（BCC）中的可行性，这些肿瘤在标准手术后复发。纳入标准为：（a）“活检证实面部 BCC 复发”；（b）“已知手术切除的日历年份”；（c）“最后一次手术切除后 10 年内复发”。纳入 2011 年 1 月 1 日至 2020 年 12 月 31 日期间接受标准 5 周免疫冷冻治疗周期（5 周内每天应用咪喹莫特和第 14 天冷冻治疗）的病例。采用描述性统计、Kaplan-Meier 方法和 Cox 比例风险模型进行分析，显著性水平为 < 0.05。在 27 例 BCC 中，20 例（74.1% ± 8.4%）在 1 个免疫冷冻周期后完全清除。其余 2 例在重复周期后完全清除，1 例患者选择手术，4 例 BCC 尽管接受了额外的免疫冷冻周期但未清除（可行性为 81.5% ± 7.5%）。在有临床结局“免疫冷冻完全清除”的 22 例肿瘤中，3 例 BCC 在 9、28 和 50 个月时复发。总体而言，5 年治疗有效率为 60.2% ± 13.4%（平均随访 94.6 ± 15.1 个月）。在总共 27 例 BCC 中，20 例（74.1%）在手术后复发，在个性化随访结束时无肿瘤（5 年随访时无肿瘤患者为 66.7% ± 12.4%）。免疫冷冻治疗前的肿瘤复发次数是免疫冷冻治疗后肿瘤进展的唯一预测因素（ = 0.012）。综上，免疫冷冻疗法可作为手术切除后复发的特定面部 BCC 的替代、确定性治疗方法进一步评估。
