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Cryosurgery for basal cell carcinoma treated in primary care

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Abstract

Background

Basal cell carcinoma (BCC) is a very common skin cancer in Caucasians. Although rarely life-threatening, it can be locally destructive and consumes a considerable amount of health expenditure. Treatments that are safe, cost-effective and can be carried out in primary care with a high cure rate and good cosmetic results for selected cases of BCC need to be explored.

Aims

This retrospective study was carried out to assess whether cryosurgery is a reasonable option for treating select cases of basal cell carcinomas (BCCs) in primary care under local anaesthetic by an expert cryosurgeon.

Method

The treatment and outcome of 184 consecutive, histologically diagnosed BCCs in 138 patients in one primary care setting over a 5-year period was analysed.

Results

One hundred (54%) BCCs were treated with cryosurgery, 57 (31%) treated by excision in primary care, 13 (7%) by photodynamic therapy (PDT), 12 (7%) by referral to plastic surgery mostly for flaps or grafts and 2 (1%) by imiquimod 5%.

Conclusions

Just over half of all BCCs in this survey were treated using cryosurgery (100 = 54%) and 79 were followed up for more than 5 years. The cure rate with cryosurgery was 95% after 5 years (95% CI, 0.8686–0.9837) with an excellent or good cosmetic outcome in 92%.

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Acknowledgements

We would like to thank Tadhg O’Shea of the Institute of Technology, Tralee, Co Kerry, Ireland, for statistical analysis and to all our local GPs for referring their patients to us. Thanks also to our hospital-based colleagues in plastic surgery, histopathology and dermatology. Finally, a word of thanks to all our patients who entrusted us with their care.

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Authors and Affiliations

  1. The Ashe Street Clinic, Tralee, Co Kerry, Ireland

    David Buckley, Christa Marczuk & Thomas Kennedy

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  1. David Buckley
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  2. Christa Marczuk
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  3. Thomas Kennedy
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Correspondence to David Buckley.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Buckley, D., Marczuk, C. & Kennedy, T. Cryosurgery for basal cell carcinoma treated in primary care. Ir J Med Sci 189, 1183–1187 (2020). https://doi.org/10.1007/s11845-020-02188-5

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