Cryosurgery versus pulsed co[2] laser in treatment of basal cell carcinoma

ABSTRACT

Basal cell carcinoma [BCC] is the most common human malignancy and the most common malignant skin tumor. Although BCC has a low mortality, it has a large morbidity. Several modalities have been used in the treatment of BCC, however, it remains to be established which one is the best in terms of safety, cosmetic outcome and cost-effectiveness. Cryosurgery for BCC treatment is an approach currently in progress, with many technical and prognostic advantages. Also, CO2 laser ablation has been advocated as an alternative therapeutic modality for basal cell carcinoma. The present study was designed to evaluate and compare the outcome of two of the most commonly used modalities, the cryosurgery and pulsed CO2 laser, in treatment of superficial [S] and nodular [N] BCCs. Thirty-two patients with histopathologically verified BCCs, 17 superficial and 15 nodular lesions were selected and included in 2 equal groups group I, treated by cryosurgery and group II by pulsed CO2 laser. Follow-up period was restricted to 1 year with close follow-up for the first 3 months. The efficacy, tolerability, and cosmetic outcome were all assessed. While complete [100%] cure was reported with either procedures in treatment of superficial types of BCC, cryosurgery was found significantly more successful in treating nodular BCCs [P=0.04] and the overall efficacy was significantly better with cryosurgery than CO2 laser [P=O.04]. The healing time was shorter with cryosurgery than CO2 laser, with less erythema [P<0.001] and less wound leakage [P<0.008]. No statistically significant difference was found between either procedures concerning the cosmetic outcome. In conclusion, cryosurgery is an easy, quick, low-cost and well-tolerated therapeutic modality that offers an acceptable cure rate with good functional and cosmetic results in BCCs treatment