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Management of complex head-and-neck basal cell carcinomas using a combined reflectance confocal microscopy/optical coherence tomography: a descriptive study

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Abstract

Introduction

Recently, a combined reflectance confocal microscopy (RCM)–optical coherence tomography (OCT) has been tested for the diagnosis of basal cell carcinoma (BCC). Evaluating the role of RCM–OCT in management of complex BCCs has not been studied. The objective of the study was to investigate the utility of a new combined RCM–OCT device in the evaluation and management of complex BCCs in a descriptive study.

Methods

Prospective study of consecutive cases (July 2018–June 2019) of biopsy-proven ‘complex’ BCC defined as BCC in the head-and-neck area with multiple high-risk criteria such as large size in the mask area, multiple recurrences, and high-risk subtype. All cases were evaluated with a combined RCM–OCT device that provided simultaneous image viewing on a screen. Lesions were evaluated bedside with RCM–OCT according to previously described criteria.

Results

Ten patients with complex head-and-neck BCCs had mean age of 73.1 ± 13.0 years. Six (60%) patients were males. Mean BCC clinical size was 1.9 ± 1.2 cm (range 0.6–4.0 cm). RCM detected residual BCC in 8 out of 10 cases (80%) and OCT detected residual BCC in all 10 cases (100%). Six BCCs (60%) had a depth estimate of > 1000 µm under OCT. In five cases, (50%) RCM–OCT imaging results led to a change/modification in BCC management.

Conclusion

The use of a combined RCM–OCT device may help in the evaluation of complex head-and-neck BCCs by guiding treatment selection and defining the extent of surgery.

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Acknowledgements

Development of the RCM–OCT microscope was supported by NIH Grants (NCI SBIR R44CA162561, NIBIB R01EB020029 and NCI MSK Cancer Center P30CA008748). Further technical support (provision, troubleshooting, software modifications, and image analysis) was provided by Drs. Nicusor Iftimia and Gopi Maguluri, Physical Sciences Inc. (Andover, MA, USA).

Funding

This research was funded in part by a Grant from the National Cancer Institute/National Institutes of Health (P30-CA008748) made to Memorial Sloan Kettering Cancer Center.

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Author notes

  1. Cristian Navarrete-Dechent and Saud Aleissa have contributed equally

Authors and Affiliations

  1. Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile

    Cristian Navarrete-Dechent

  2. Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 16 E 60th Street, New York, NY, USA

    Cristian Navarrete-Dechent, Saud Aleissa, Miguel Cordova, Konstantinos Liopyris, Aditi Sahu, Anthony M. Rossi, Erica H. Lee & Kishwer S. Nehal

  3. University of Athens, Athens, Greece

    Konstantinos Liopyris

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  1. Cristian Navarrete-Dechent
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Contributions

CN-D: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. SA: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. MC: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. KL: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. AS: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. EHL: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. AMR: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published. KSN: acquisition, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published.

Corresponding author

Correspondence to Kishwer S. Nehal.

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Conflict of interest

Anthony Rossi: Dr. Rossi has no relevant conflicts of interest related to this manuscript, but served on advisory board, as a consultant, or given educational presentations: for Allergan, Inc; Galderma Inc; Evolus Inc; Elekta; Biofrontera, Quantia; Merz Inc; Dynamed; Skinuvia, Perf-Action. Nehal KS: received royalties from publishing companies for books and book chapters.

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IRB approval status: MSKCC #99-099.

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Navarrete-Dechent, C., Aleissa, S., Cordova, M. et al. Management of complex head-and-neck basal cell carcinomas using a combined reflectance confocal microscopy/optical coherence tomography: a descriptive study. Arch Dermatol Res 313, 193–200 (2021). https://doi.org/10.1007/s00403-020-02037-6

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