@article{3077375,
    title = "Diagnosis and treatment of basal cell carcinoma: European consensus–based interdisciplinary guidelines",
    author = "Peris, K. and Fargnoli, M.C. and Garbe, C. and Kaufmann, R. and Bastholt, L. and Seguin, N.B. and Bataille, V. and Marmol, V.D. and Dummer, R. and Harwood, C.A. and Hauschild, A. and Höller, C. and Haedersdal, M. and Malvehy, J. and Middleton, M.R. and Morton, C.A. and Nagore, E. and Stratigos, A.J. and Szeimies, R.-M. and Tagliaferri, L. and Trakatelli, M. and Zalaudek, I. and Eggermont, A. and Grob, J.J. and European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC)",
    journal = "EUROPEAN JOURNAL OF CANCER",
    year = "2019",
    volume = "118",
    pages = "10-34",
    publisher = "Elsevier Ireland Ltd",
    doi = "10.1016/j.ejca.2019.06.003",
    keywords = "fluorouracil;  imiquimod;  sonidegib;  vismodegib, Article;  basal cell carcinoma;  basal cell nevus syndrome;  cancer recurrence;  cauterization;  consensus;  cryotherapy;  etiology;  follow up;  genetics;  histogenesis;  histopathology;  human;  immunotherapy;  laser surgery;  nodular basal cell carcinoma;  photodynamic therapy;  practice guideline;  priority journal;  risk;  risk factor;  skin examination;  superficial basal cell carcinoma;  ultraviolet radiation;  basal cell carcinoma;  clinical decision making;  consensus;  consensus development;  Europe;  mortality;  oncology;  pathology;  patient selection;  practice guideline;  predictive value;  prognosis;  risk assessment;  skin tumor, Carcinoma, Basal Cell;  Clinical Decision-Making;  Consensus;  Europe;  Humans;  Medical Oncology;  Patient Selection;  Predictive Value of Tests;  Prognosis;  Risk Assessment;  Risk Factors;  Skin Neoplasms",
    abstract = "Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer collaborated to develop recommendations on diagnosis and treatment of BCC. A new classification into ‘easy-to-treat (common) BCC and ‘difficult-to-treat’ BCC is proposed. Diagnosis is based on clinicodermatoscopic features for ‘easy-to-treat’ BCCs. Histopathological confirmation is mandatory in ambiguous lesions and in BCCs located in high-risk areas. The first-line treatment of ‘easy-to-treat’ BCC is complete surgery. Microscopically controlled surgery shall be offered for high-risk BCC, recurrent BCC and BCC in critical anatomical sites. Topical therapies (5% imiquimod, 5% fluorouracil) and destructive approaches (curettage, electrocautery, cryotherapy, laser ablation) should be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial BCC and thin nodular BCC. The therapy for a ‘difficult-to-treat’ BCC should preferentially be discussed by a multidisciplinary tumour board. Hedgehog inhibitors, vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCCs. Immunotherapy with anti–programmed cell death 1 (PD-1) antibodies is a promising therapeutic option, currently being investigated in clinical trials. Radiotherapy represents a valid alternative to surgery for BCC on the face, especially in elderly patients. In patients with naevoid basal cell carcinoma syndrome (NBCCS), close surveillance and regular skin examinations are required to diagnose and treat BCCs at early stage. Long-term follow-up is recommended in patients with high-risk BCC subtypes, high-risk sites, multiple BCCs and NBCCS. © 2019 Elsevier Ltd"
}