[2 min read] Surgery vs curettage & imiquimod for nodular BCC

Nodular basal cell carcinoma (BCC) is most often treated with surgical excision. However, interest is increasing in minimally invasive treatments for these low-risk skin cancers. A new study reviewed the effectiveness of surgical excision compared with curettage and imiquimod cream in treating nodular BCC.

One hundred and forty-five patients with nodular BCC were included in a randomised, controlled non-inferiority trial, where they were randomly assigned to either a curettage and imiquimod cream group (73 patients) or a surgical excision group (72 patients).

The Dutch study found that the proportion of patients free of recurrence after 12 months was 86.3 per cent (63 out of 73) for the curettage and imiquimod group and 100 per cent (72 out of 72) for the surgical excision group. The difference in efficacy was −13.7 per cent favouring surgical excision.

Researchers concluded that non-inferiority of curettage and imiquimod cream could not be concluded. Given the still high efficacy of curettage and imiquimod cream and the indolent growth pattern of nodular BCC, they determined that curettage and imiquimod could still be a valuable treatment option with the possibility to prevent overuse of excisions. However, it cannot replace surgical excision.

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Source: https://www.jaad.org/article/S0190-9622(20)30666-6/fulltext

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