Recurrence Rate and Esthetic Outcome After Excision of Basal Cell Carcinomas Excluded From Trial NCT00515970 - Full Text View

Purpose

Currently, we conduct a prospective, randomized trial comparing the outcome of surgical excision with the outcome of curettage in nodular and superficial BCCs. Larger BCCs and micronodular or sclerosing BCCs are not included in the randomized study. They are mainly operated using three-dimensional histology (3D-histology, micrographic surgery). In this observational study we measure the cosmetic result and the recurrence rate of all BCCs not included in the randomized trial.

Condition	Intervention
Carcinoma, Basal Cell	Procedure: 3D-histology Procedure: Shave excision

Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Observational Study: Recurrence Rate and Esthetic Outcome After Excision of Basal Cell Carcinomas Excluded From Trial NCT00515970

Resource links provided by NLM:

MedlinePlus related topics: Cancer

U.S. FDA Resources

Further study details as provided by University Hospital Tuebingen:

Primary Outcome Measures:

Recurrence of basal cell carcinoma (BCC) [ Time Frame: Within 4 years after surgery ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:

Subjective assessment of the esthetic outcome of the scar on a scale of excellent, good, satisfying, moderate, unfavorable; done by a private practitioner. [ Time Frame: 12 and 48 months after surgery ] [ Designated as safety issue: No ]
Subjective assessment of the esthetic outcome of the scar on a scale of excellent, good, satisfying, moderate, unfavorable; done by the patient. [ Time Frame: 12 and 48 months after surgery ] [ Designated as safety issue: No ]

Biospecimen Retention: Samples Without DNA

Paraffinized histology blocks and sections.

Estimated Enrollment:	800
Study Start Date:	December 2007
Estimated Study Completion Date:	December 2013
Estimated Primary Completion Date:	December 2013 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
1. 3D-histology Nodular, micronodular, or sclerosing BCCs	Procedure: 3D-histology The tumor is marked at the 12 o'clock-position. Excision with a safety margin between 2 and 10 mm, depending on tumor size and location. Plastic reconstruction. Removal of the specimen's margins and base as thin layers, using a scalpel. These primarily three-dimensional layers of the specimen's borders are flattened to one level and microscopically screened for tumor cells. 3D-histology is combined with representative vertical sections for histologic diagnosis. Consecutive excisions are performed topographically at the tumor-positive areas and 3D-histology is repeated until tumor-free margins are obtained. Other Names: Micrographic surgery Histographic surgery Mohs surgery
2. Shave excision Superficial BCCs	Procedure: Shave excision Tumor removal by shave excision with a safety margin. Healing by secondary intention. Histologic diagnosis of BCC type (nodular, superficial, morpheaform, micronodular, other type, mixed type) or diagnosis of another tumor than BCC. Comment on complete removal (R0 versus R1).

Groups/Cohorts

Assigned Interventions

1. 3D-histology

Nodular, micronodular, or sclerosing BCCs

Procedure: 3D-histology

The tumor is marked at the 12 o'clock-position. Excision with a safety margin between 2 and 10 mm, depending on tumor size and location. Plastic reconstruction. Removal of the specimen's margins and base as thin layers, using a scalpel. These primarily three-dimensional layers of the specimen's borders are flattened to one level and microscopically screened for tumor cells. 3D-histology is combined with representative vertical sections for histologic diagnosis. Consecutive excisions are performed topographically at the tumor-positive areas and 3D-histology is repeated until tumor-free margins are obtained.

Other Names:

Micrographic surgery
Histographic surgery
Mohs surgery

2. Shave excision

Superficial BCCs

Procedure: Shave excision

Tumor removal by shave excision with a safety margin. Healing by secondary intention. Histologic diagnosis of BCC type (nodular, superficial, morpheaform, micronodular, other type, mixed type) or diagnosis of another tumor than BCC. Comment on complete removal (R0 versus R1).

Detailed Description:

Disinfection
Local anesthesia
Surgery
Dressing
Preparation with paraffin for histopathologic evaluation
Staining with hematoxylin-eosin
Adjuvant radiotherapy is not applied in any of our patients.
If histopathology discovers another tumor than BCC, the tumor is excluded.
If recurrence is suspected, a punch biopsy is taken. If recurrence is confirmed, the endpoint is achieved.
Patients who provide no feedback receive phone calls.
The patient receives a letter containing a list of the BCCs treated within the study. She or he is asked to visit the private practitioner with the list after 12 and 48 months (+/- 30 days) referring to the last operation in the recruitment period. The practitioner or the patient return the questionnaire to our department.
The letter contains a questionnaire about suspicion of recurrence of BCC.
The patient is asked to assess the esthetic outcome on a scale of excellent, good, satisfactory, mediocre, and poor.
The physician is asked to assess the esthetic outcome on a scale of excellent, good, satisfactory, mediocre, and poor.
When follow-up is closed for an individual patient, the reason is recorded:
1. Planned end of follow-up after 48 months
2. Patient has moved.
3. Death (date of death)
4. Consent withdrawn
5. Meanwhile, the patient has become so ill or high-maintenance that no more follow-up visits can be planned.
6. Recurrence of all of the patient's BCCs with histopathologic confirmation.

Eligibility

Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

BCCs excluded from the randomized trial NCT00515970

Criteria

Inclusion Criteria:

BCCs excluded from the randomized trial NCT00515970

Exclusion Criteria:

Treatment other than with 3D-histology or shave excision (e.g. deep surgical excision without 3D-histology)

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00639652

Locations

Germany
Eberhard Karls University, Department of Dermatology
Tuebingen, Germany, 72076

Sponsors and Collaborators

University Hospital Tuebingen

Investigators

Study Chair:	Helmut Breuninger, M.D.	Eberhard Karls University Tuebingen, Department of Dermatology
Principal Investigator:	Kay Brantsch, M.D.	Eberhard Karls University Tuebingen, Department of Dermatology

More Information

No publications provided

Responsible Party:	Helmut Breuninger, Department of Dermatology, Eberhard Karls University
ClinicalTrials.gov Identifier:	NCT00639652 History of Changes
Other Study ID Numbers:	16/2008BO2
Study First Received:	March 14, 2008
Last Updated:	March 14, 2008
Health Authority:	Germany: Federal Ministry of Education and Research

Keywords provided by University Hospital Tuebingen:

Carcinoma, Basal Cell
3D-histology
Micrographic surgery
Mohs surgery

Shave excision
Recurrence
Esthetic outcome

Additional relevant MeSH terms:

Carcinoma
Carcinoma, Basal Cell
Recurrence
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type

Neoplasms
Neoplasms, Basal Cell
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on May 23, 2013