From the Guidelines
Follow-up treatment for basal cell carcinoma (BCC) excision from the nose is crucial due to the high risk of recurrence, with 30% to 50% of patients developing another BCC within 5 years.
Key Factors Influencing Prognosis
- Tumour site: Lesions on the central face, especially around the eyes, nose, lips, and ears, are at higher risk of recurrence 1
- Tumour size: Increasing size confers higher risk of recurrence 1
- Histological subtype: Certain subtypes confer higher risk of recurrence 1
Follow-up Recommendations
- Close follow-up: Patients should be closely followed up, especially during the short-term period after diagnosis of the first lesion, as development of a second BCC is most likely during this time 1
- Long-term surveillance: Continued long-term surveillance of these patients is essential, as is patient education about the values of sun protection and regular self-examination of the skin 1
- Regular check-ups: Regular check-ups with a dermatologist are necessary to monitor for any signs of recurrence or new lesions 1
From the Research
Follow-up Treatment for Basal Cell Carcinoma (BCC) Excision from the Nose
- The follow-up treatment for a patient after BCC excision from the nose involves regular monitoring to detect any recurrence or development of new BCCs 2.
- According to a study published in 2001,27% of dermatologists reported that they would not review further after excision of a 'well-defined' BCC from inside a central 'T' area on the face, while 37% reported that they would review on one occasion, and 36% reported that they review more than once 2.
- A study published in 2024 found that patients with high-risk facial BCC treated with interferon had a complete response rate of 73.3% and a recurrence rate of 12.3% after a mean follow-up of 55 months 3.
- The European consensus-based interdisciplinary guidelines recommend long-term follow-up for patients with high-risk BCC subtypes, high-risk sites, multiple BCCs, and naevoid basal cell carcinoma syndrome (NBCCS) 4.
- The treatment modality utilized is dependent on both the tumor type and the patient, and evidence-based research is necessary to choose between therapies 5, 6.
Treatment Options
- Surgical excision, Mohs surgery, and cryosurgery are the three standard therapies of choice for BCC treatment 5.
- Other treatment modalities, such as photodynamic therapy, topical imiquimod, and topical 5-fluorouracil, may be considered for low-risk superficial BCC 4, 6.
- Radiotherapy represents a valid alternative to surgery for BCC on the face, especially in elderly patients 4.
- Hedgehog inhibitors, vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCCs 4.