Reflectance confocal microscopy-guided carbon dioxide laser ablation of low-risk basal cell carcinomas: A prospective study.
Adult
Aged
Biopsy
Carcinoma, Basal Cell
/ diagnostic imaging
Feasibility Studies
Female
Follow-Up Studies
Humans
Laser Therapy
/ instrumentation
Lasers, Gas
/ therapeutic use
Male
Microscopy, Confocal
Middle Aged
Neoplasm Recurrence, Local
/ diagnostic imaging
Neoplasm, Residual
Prospective Studies
Risk Assessment
Skin
/ diagnostic imaging
Skin Neoplasms
/ diagnostic imaging
Treatment Outcome
ablation
basal cell carcinoma
carbon dioxide laser
diagnosis
follow-up
laser
reflectance confocal microscopy
treatment
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
22
02
2019
revised:
13
04
2019
accepted:
08
06
2019
pubmed:
17
6
2019
medline:
15
2
2020
entrez:
17
6
2019
Statut:
ppublish
Résumé
Basal cell carcinoma (BCC) treatment modalities can be stratified by tumor subtype and recurrence risk. The main limitation of nonsurgical treatment modalities is the lack of histopathologic confirmation. Reflectance confocal microscopy (RCM) is a noninvasive imaging device that provides quasihistologic images. To evaluate the feasibility and efficacy of RCM-guided carbon dioxide (CO Prospective study with biopsy specimen-proven low-risk BCCs imaged with RCM. RCM was performed on these sites before and after ablation. If residual tumor was found, a new series of laser passes were performed. The patients were then monitored for recurrence clinically and with RCM. Twenty-two tumor sites in 9 patients (5 men, 4 women) were imaged and treated. Median age was 59 ± 12.9 years (range, 30-74 years). Mean tumor size was 7.7 mm (range, 5-10 mm). Residual tumor was identified in 5 of 22 cases (22.7%) under RCM on immediate first-pass postablation sites, prompting additional laser passes. Median follow-up was 28.5 months (range, 22-32 months) with no recurrences found. Addition of RCM to laser ablation workflow can detect subclinical persistent tumor after initial ablation and may serve as an aid to increase the efficacy of laser ablation.
Sections du résumé
BACKGROUND
BACKGROUND
Basal cell carcinoma (BCC) treatment modalities can be stratified by tumor subtype and recurrence risk. The main limitation of nonsurgical treatment modalities is the lack of histopathologic confirmation. Reflectance confocal microscopy (RCM) is a noninvasive imaging device that provides quasihistologic images.
OBJECTIVE
OBJECTIVE
To evaluate the feasibility and efficacy of RCM-guided carbon dioxide (CO
METHODS
METHODS
Prospective study with biopsy specimen-proven low-risk BCCs imaged with RCM. RCM was performed on these sites before and after ablation. If residual tumor was found, a new series of laser passes were performed. The patients were then monitored for recurrence clinically and with RCM.
RESULTS
RESULTS
Twenty-two tumor sites in 9 patients (5 men, 4 women) were imaged and treated. Median age was 59 ± 12.9 years (range, 30-74 years). Mean tumor size was 7.7 mm (range, 5-10 mm). Residual tumor was identified in 5 of 22 cases (22.7%) under RCM on immediate first-pass postablation sites, prompting additional laser passes. Median follow-up was 28.5 months (range, 22-32 months) with no recurrences found.
CONCLUSIONS
CONCLUSIONS
Addition of RCM to laser ablation workflow can detect subclinical persistent tumor after initial ablation and may serve as an aid to increase the efficacy of laser ablation.
Identifiants
pubmed: 31202871
pii: S0190-9622(19)30977-6
doi: 10.1016/j.jaad.2019.06.014
pmc: PMC6777957
mid: NIHMS1531870
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
984-988Subventions
Organisme : NCI NIH HHS
ID : L30 CA231456
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
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