Long-term Recurrence after Curettage ± Electrodesiccation for Basal Cell Carcinoma: A Nationwide Cohort Study of 47,358 Tumours from Dermatology Practices
DOI:
https://doi.org/10.2340/actadv.v106.adv-2025-0079Keywords:
basal cell carcinoma, curettage, dermatology practice, epidemiology, recurrence, surgeryAbstract
The incidence of basal cell carcinoma is increasing globally, with Denmark showing a 220% rise between 2013 and 2021, underscoring the need to optimize treatment strategies. Curettage with or without electrodesiccation (C±E) is commonly used, yet updated tumour-specific recurrence data are limited. Using the Danish Skin Cancer Registry, we assessed long-term recurrence after C±E for 47,358 basal cell carcinomas treated in office-based dermatological practices between 2013 and 2022. Follow-up began one year after treatment, and recurrence was evaluated using Kaplan–Meier analysis and Cox regression to estimate cumulative recurrence rates and hazard ratios (HR) by tumour characteristics. The 5-year recurrence rate was 9.9% (95% CI 9.4–10.3), increasing to 13.3% (12.6–14.1) at 8 years. Head and neck tumours had the highest recurrence (25.1% at 8 years; HR 2.25, 2.00–2.53), as did tumours >10 mm (16.7% at 8 years; HR 1.80, 1.62–1.99), while superficial basal cell carcinomas had the lowest recurrence (8.4% at 8 years; HR 0.46, 0.38–0.56). Incomplete follow-up may have introduced bias in recurrence estimates. This nationwide study, the largest to date with up to 8 years of follow-up, shows that C±E remains a viable treatment, but careful tumour selection is essential to optimize long-term outcomes.
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Urban K, Mehrmal S, Uppal P, Giesey RL, Delost GR. The global burden of skin cancer: a longitudinal analysis from the Global Burden of Disease Study, 1990-2017. JAAD Int 2021; 2: 98–108. DOI: https://doi.org/10.1016/j.jdin.2020.10.013
Sieborg J, Haedersdal M, Lei U, Sølvsten H, Olesen AB, Vinding GR, et al. Incidence and geographic differences in keratinocyte carcinoma and Bowen’s disease in office‐based dermatological practice between 2013 and 2022: a nationwide Danish registry‐based study. JEADV Clinical Practice 2024; 3: 1164–1174 DOI: https://doi.org/10.1002/jvc2.478
Gjerstorff ML. The Danish cancer registry. Scand J Public Health 2011; 39: 42–45. DOI: https://doi.org/10.1177/1403494810393562
Peris K, Fargnoli MC, Kaufmann R, Arenberger P, Bastholt L, Seguin NB, et al. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023. Eur J Cancer 2023; 192: 113254. DOI: https://doi.org/10.1016/j.ejca.2023.113254
Patel PV, Pixley JN, Dibble HS, Feldman SR. Recommendations for cost-conscious treatment of basal cell carcinoma. Dermatol Ther 2023; 13: 1959–1971. DOI: https://doi.org/10.1007/s13555-023-00989-x
Spiller WF, Spiller RF. Treatment of basal cell epithelioma by curettage and electrodesiccation. J Am Acad Dermatol 1984; 11: 808–814. DOI: https://doi.org/10.1016/S0190-9622(84)80457-0
Silverman MK, Kopf AW, Grin CM, Bart RS, Levenstein MJ. Recurrence rates of treated basal cell carcinomas. Part 2: curettage-electrodesiccation. J Dermatol Surg Oncol 1991; 17: 720–726. DOI: https://doi.org/10.1111/j.1524-4725.1991.tb03425.x
Rodriguez-Vigil T, Vázquez-López F, Perez-Oliva N. Recurrence rates of primary basal cell carcinoma in facial risk areas treated with curettage and electrodesiccation. J Am Acad Dermatol 2007; 56: 91–95. DOI: https://doi.org/10.1016/j.jaad.2006.07.007
Kopf AW, Bart RS, Schrager D, Lazar M, Popkin GL. Curettage-electrodesiccation treatment of basal cell carcinomas. Arch Dermatol 1977; 113: 439–443. DOI: https://doi.org/10.1001/archderm.1977.01640040047006
Blixt E, Nelsen D, Stratman E. Recurrence rates of aggressive histologic types of basal cell carcinoma after treatment with electrodesiccation and curettage alone. Dermatol Surg 2013; 39: 719–725. DOI: https://doi.org/10.1111/dsu.12122
Rowe DE, Carroll RJ, Day CL. Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. J Dermatol Surg Oncol 1989; 15: 315–328. DOI: https://doi.org/10.1111/j.1524-4725.1989.tb03166.x
Kim JYS, Kozlow JH, Mittal B, Moyer J, Olencki T, Rodgers P, et al. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol 2018; 78: 540–559. DOI: https://doi.org/10.1016/j.jaad.2017.10.006
Lamberg AL, Sølvsten H, Lei U, Vinding GR, Stender IM, Jemec GBE, et al. The Danish nonmelanoma skin cancer dermatology database. Clin Epidemiol 2016; 8: 633–636. DOI: https://doi.org/10.2147/CLEP.S99464
Schmidt M, Schmidt SAJ, Adelborg K, Sundbøll J, Laugesen K, Ehrenstein V, et al. The Danish health care system and epidemiological research: from health care contacts to database records. Clin Epidemiol 2019; 11: 563–591. DOI: https://doi.org/10.2147/CLEP.S179083
Salasche SJ. Curettage and electrodesiccation in the treatment of midfacial basal cell epithelioma. J Am Acad Dermatol 1983; 8: 496–503. DOI: https://doi.org/10.1016/S0190-9622(83)70055-1
Thissen MR, Neumann MH, Schouten LJ. A systematic review of treatment modalities for primary basal cell carcinomas. Arch Dermatol 1999; 135: 1177–1183. DOI: https://doi.org/10.1001/archderm.135.10.1177
Chren MM, Linos E, Torres JS, Stuart SE, Parvataneni R, Boscardin WJ. Tumor recurrence 5 years after treatment of cutaneous basal cell carcinoma and squamous cell carcinoma. J Invest Dermatol 2013; 133: 1188–1196. DOI: https://doi.org/10.1038/jid.2012.403
Lubeek SFK, Arnold WP. A retrospective study on the effectiveness of curettage and electrodesiccation for clinically suspected primary nodular basal cell carcinoma. Br J Dermatol 2016; 175: 1097–1098. DOI: https://doi.org/10.1111/bjd.14770
Werlinger KD, Upton G, Moore AY. Recurrence rates of primary nonmelanoma skin cancers treated by surgical excision compared to electrodesiccation-curettage in a private dermatological practice. Dermatol Surg 2002; 28: 1138–1142. DOI: https://doi.org/10.1046/j.1524-4725.2002.02110.x
Williamson GS, Jackson R. Treatment of basal cell carcinoma by electrodesiccation and curettage. Can Med Assoc J 1962; 86: 855–862.
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