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Sponsored by: |
University Hospital Tuebingen |
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Information provided by: | University Hospital Tuebingen |
ClinicalTrials.gov Identifier: | NCT00515970 |
Basal cell carcinoma (BCC) is the most frequent skin cancer. Uncontrolled growth destroys local anatomic structures. There are various treatment alternatives with different recurrence rates and expenses. After surgical excision, the recurrence rate is in between 3 and 4% and the procedure is relatively expensive. Photodynamic therapy as well as imiquimod 5% are expensive therapies with high recurrence rates, that lack histologic evidence of BCC. Cryosurgery and curettage are inexpensive, although the recurrence rates are higher than after surgical excision.
This prospective, randomized trial compares recurrence rates, cosmetic outcome, and surgery-related complications after curettage versus surgical excision in nodular and superficial BCC. About 600 tumors will be included. One half is treated by curettage, the other half by surgical excision. The follow-up period is four years. If the difference between recurrence rates is ≤7% and the cosmetic outcome as well as the surgery-related complications are not worse after curettage, surgical excision must be considered an overtreatment.
Condition | Intervention |
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Carcinoma, Basal Cell |
Procedure: Curettage Procedure: Deep excision Procedure: Shave excision |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study |
Official Title: | Prospective Randomized Trial: Curettage Versus Excision in Nodular and Superficial Basal Cell Carcinomas |
Estimated Enrollment: | 400 |
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) |
Arms | Assigned Interventions |
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1: Experimental
Clinical or histologic diagnosis of nodular BCC
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Procedure: Curettage
Curettage without subcutaneous tissue using a 7 mm ring curette and the "fountain-pen technique" (http://www.biopsypunch.com/kuerettagetechnik.htm; accessed on March 13, 2008). The curette is held between the thumb, index and middle finger. This method of holding enables precise guiding of the instrument, so that the piece of tissue can be removed in one well-targeted incision. After macroscopically complete removal, a safety margin is removed with the curette. It is used for histology to distinguish between R0 (excision margin without tumor cells) and R1 resection (excision margin containing tumor cells). Preparation with paraffin. Parallel, vertical sections for histologic diagnosis. Hematoxylin-eosin staining. Measurement of tumor thickness in mm.
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2: Active Comparator
Clinical or histologic diagnosis of nodular BCC
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Procedure: Deep excision
12 o'clock mark. Excision with a scalpel down to the subcutaneous level. Plastic reconstruction. Three vertical, parallel bread loaf sections for histology. Preparation with paraffin. Staining with hematoxylin-eosin. Histologic diagnosis including report of tumor thickness in mm. Comment on complete removal (R0 versus R1). In case of R1 excision directed reoperations are performed until R0 is achieved.
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3: Experimental
Clinical or histologic diagnosis of superficial BCC
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Procedure: Curettage
Curettage with a 7 mm ring curette with the "potato-peeler technique" (http://www.biopsypunch.com/kuerettagetechnik.htm; accessed on March 13, 2008). The handle of the curette is held in the distal inter-digital fold of the index finger, and supported by the other fingers of the curetting hand. The thumbs serve to provide a stable base. This technique makes it possible to guide the instrument, applying greater pressure, but accuracy is reduced. After macroscopically complete removal, a safety margin is removed with the curette. It is used for histology to distinguish between R0 (excision margin without tumor cells) and R1 resection (excision margin containing tumor cells). Preparation with paraffin. Parallel, vertical sections for histologic diagnosis. Hematoxylin-eosin staining.
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4: Active Comparator
Clinical or histologic diagnosis of superficial BCC
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Procedure: Shave excision
Shave excision with a safety margin, using a scalpel. Wound healing by secondary intention. Preparation with paraffin. Parallel vertical bread loaf sections for histology. Staining with hematoxylin-eosin. Histologic diagnosis. Comment on complete removal (R0 versus R1). In case of R1 excision a reoperation is performed until R0 is achieved.
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Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patient Dependent Exclusion Criteria:
Tumor Exclusion Criteria:
Contact: Helmut Breuninger, M.D. | +49-70 71-29 ext 8 45 90 | helmut.breuninger@med.uni-tuebingen.de |
Contact: Kay D Brantsch, M.D. | +49-1 72 ext 3 77 58 53 | Kay.Brantsch@med.uni-tuebingen.de |
Germany, Baden-Wuerttemberg | |
Department of Dermatology, Eberhard Karls University | Recruiting |
Tuebingen, Baden-Wuerttemberg, Germany, 72076 |
Study Chair: | Helmut Breuninger, M.D. | Department of Dermatology, Eberhard Karls University Tuebingen |
Principal Investigator: | Kay D Brantsch, M.D. | Department of Dermatology, Eberhard Karls University Tuebingen |
Responsible Party: | Eberhard Karls University Tuebingen, Medical School ( Bettina Faust ) |
Study ID Numbers: | E.03.26007.1 |
Study First Received: | August 13, 2007 |
Last Updated: | March 14, 2008 |
ClinicalTrials.gov Identifier: | NCT00515970 |
Health Authority: | Germany: Federal Ministry of Education and Research |
Carcinoma, Basal Cell Curettage Excision |
Recurrence Complication Esthetic outcome |
Carcinoma, Basal Cell Recurrence Neoplasms, Glandular and Epithelial Carcinoma |
Neoplasms Neoplasms by Histologic Type Neoplasms, Basal Cell |