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Article

Treatment of Basal Cell Carcinoma with Electrochemotherapy: Insights from the InspECT Registry (2008–2019)

1
Department of Otolaryngology-Head and Neck Surgery, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
2
South Tees NHS Foundation Trust, Middlesbrough TS4 3BW, UK
3
Department of Plastic Surgery, St. George’s University Hospitals NHS Foundation Trust, London SW17 0QT, UK
4
Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia
5
School of Surgery, University of Padova, 27100 Padova, Italy
6
Dermatology Unit, Department of Internal Medicine and Medical Specialties, University “La Sapienza”, 00042 Rome, Italy
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Department of Dermatology and Allergology, Albert Szent-Györgyi Clinical Centre, University of Szeged, 6700 Szeged, Hungary
8
Department of Oncology, Herlev and Gentofte Hospital, University of Copenhagen, 2730 Herlev, Denmark
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Cork Cancer Research Centre, University College Cork, T12 YN60 Cork, Ireland
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Department of Plastic Surgery, Cork University Hospital, T12 DC4A Cork, Ireland
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Department of Medical Sciences, Dermatologic Clinic, University of Turin, 10094 Turin, Italy
12
Department of Dermatologic Surgery and Dermatology, Artemed Fachklinik München, 81379 Munich, Germany
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Department of Dermatology and Allergology, Ludwig-Maximillian University, 80539 Munich, Germany
14
Psychology Unit, University Hospital of Padova, 35100 Padova, Italy
15
Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Pisa University Hospital, Via Paradisa 2, 56124 Pisa, Italy
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IGEA Clinical Biophysics Department, Via Parmenide 10/A, Carpi, 41012 Modena, Italy
17
Department of Surgery, Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Oxford Rd, Manchester M13 9WL, UK
*
Author to whom correspondence should be addressed.
Membership of the InspECT BCC Working Group is provided in the Acknowledgments.
Curr. Oncol. 2022, 29(8), 5324-5337; https://doi.org/10.3390/curroncol29080423
Received: 2 July 2022 / Revised: 24 July 2022 / Accepted: 26 July 2022 / Published: 28 July 2022
(This article belongs to the Special Issue Epidemiology and Risk Factors of Skin Cancer)
This prospective registry-based study aims to describe electrochemotherapy (ECT) modalities in basal cell carcinoma (BCC) patients and evaluate its efficacy, safety, and predictive factors. The International Network for Sharing Practices of Electrochemotherapy (InspECT) multicentre database was queried for BCC cases treated with bleomycin-ECT between 2008 and 2019 (n = 330 patients from seven countries, with 623 BCCs [median number: 1/patient; range: 1–7; size: 13 mm, range: 5–350; 85% were primary, and 80% located in the head and neck]). The procedure was carried out under local anaesthesia in 68% of cases, with the adjunct of mild sedation in the remaining 32%. Of 300 evaluable patients, 242 (81%) achieved a complete response (CR) after a single ECT course. Treatment naïvety (odds ratio [OR] 0.35, 95% confidence interval [C.I.] 0.19–0.67, p = 0.001) and coverage of deep tumour margin with electric pulses (O.R. 5.55, 95% C.I. 1.37–21.69, p = 0.016) predicted CR, whereas previous radiation was inversely correlated (O.R. 0.25, p = 0.0051). Toxicity included skin ulceration (overall, 16%; G3, 1%) and hyperpigmentation (overall, 8.1%; G3, 2.5%). At a 17-month follow-up, 28 (9.3%) patients experienced local recurrence/progression. Despite no convincing evidence that ECT confers improved outcomes compared with standard surgical excision, it can still be considered an opportunity to avoid major resection in patients unsuitable for more demanding treatment. Treatment naïvety and coverage of the deep margin predict tumour clearance and may inform current patient selection and management. View Full-Text
Keywords: basal cell carcinoma; skin cancer; bleomycin; electroporation; electrochemotherapy basal cell carcinoma; skin cancer; bleomycin; electroporation; electrochemotherapy
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MDPI and ACS Style

Bertino, G.; Muir, T.; Odili, J.; Groselj, A.; Marconato, R.; Curatolo, P.; Kis, E.; Lonkvist, C.K.; Clover, J.; Quaglino, P.; Kunte, C.; Spina, R.; Seccia, V.; de Terlizzi, F.; Campana, L.G.; the InspECT BCC Working Group. Treatment of Basal Cell Carcinoma with Electrochemotherapy: Insights from the InspECT Registry (2008–2019). Curr. Oncol. 2022, 29, 5324-5337. https://doi.org/10.3390/curroncol29080423

AMA Style

Bertino G, Muir T, Odili J, Groselj A, Marconato R, Curatolo P, Kis E, Lonkvist CK, Clover J, Quaglino P, Kunte C, Spina R, Seccia V, de Terlizzi F, Campana LG, the InspECT BCC Working Group. Treatment of Basal Cell Carcinoma with Electrochemotherapy: Insights from the InspECT Registry (2008–2019). Current Oncology. 2022; 29(8):5324-5337. https://doi.org/10.3390/curroncol29080423

Chicago/Turabian Style

Bertino, Giulia, Tobian Muir, Joy Odili, Ales Groselj, Roberto Marconato, Pietro Curatolo, Erika Kis, Camilla Kjaer Lonkvist, James Clover, Pietro Quaglino, Christian Kunte, Romina Spina, Veronica Seccia, Francesca de Terlizzi, Luca Giovanni Campana, and the InspECT BCC Working Group. 2022. "Treatment of Basal Cell Carcinoma with Electrochemotherapy: Insights from the InspECT Registry (2008–2019)" Current Oncology 29, no. 8: 5324-5337. https://doi.org/10.3390/curroncol29080423

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