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Reflectance confocal microscopy confirms residual basal cell carcinoma on clinically negative biopsy sites before Mohs micrographic surgery: A prospective study.
Navarrete-Dechent, Cristian; Cordova, Miguel; Aleissa, Saud; Liopyris, Konstantinos; Dusza, Stephen W; Phillips, William; Rossi, Anthony M; Lee, Erica H; Marghoob, Ashfaq A; Nehal, Kishwer S.
Afiliação
  • Navarrete-Dechent C; Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Cordova M; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Aleissa S; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Liopyris K; Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Dusza SW; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Phillips W; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Rossi AM; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Lee EH; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Marghoob AA; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
  • Nehal KS; Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: nehalk@mskcc.org.
J Am Acad Dermatol ; 81(2): 417-426, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31227277
ABSTRACT

BACKGROUND:

Biopsy specimens from patients with basal cell carcinoma (BCC) can present to surgery with no clinically residual tumor, complicating treatment decisions.

OBJECTIVE:

To evaluate reflectance confocal microscopy (RCM) for the assessment of residual BCC following biopsy.

METHODS:

Consecutive patients with biopsy-proven BCC and no clinical evidence of residual tumor who had been referred for Mohs micrographic surgery were included. Biopsy sites were imaged with a handheld RCM device. On the basis of RCM evaluation, cases were labeled RCM positive or RCM negative. Mohs micrographic surgery was performed in all cases; margins and 15-µm serial vertical sectioning were evaluated.

RESULTS:

A total of 61 patients were included (mean age, 61.7 years [standard deviation, 12.2 years]; range, 37-87 years); 60.7% were women. The mean lesion size was 5.1 mm (range, 3-12 mm); 73.8% of patients were positive on RCM, and 68.9% had residual BCC on histopathologic examination. The rates of RCM sensitivity, specificity, positive predictive value, and negative predictive value were 92.8%, 68.4%, 86.6%, and 81.2%, respectively. Three cases of BCC (high-risk, infiltrative, and basosquamous) were missed with use of RCM. When high-risk subtypes were excluded (n = 5), sensitivity and negative predictive value were both 100%.

LIMITATIONS:

RCM can miss deep-seated residual tumor.

CONCLUSION:

RCM is a valuable tool for the evaluation of residual BCC following biopsy, with the potential to reduce unnecessary surgical procedures.
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Carcinoma Basocelular Limite: Adulto / Idoso / Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: J Am Acad Dermatol Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Carcinoma Basocelular Limite: Adulto / Idoso / Feminino / Humanos / Masculino / Meia-Idade Idioma: Inglês Revista: J Am Acad Dermatol Ano de publicação: 2019 Tipo de documento: Artigo