Cure rate of low-risk superficial basal cell carcinoma treated with topical 5-fluorouracil

Abstract

Background: Basal cell carcinoma (BCC) is the most common cancer in the world making this condition a public health issue. Superficial BCC (sBCC) is a subtype with indolent behavior.  The gold standard treatment is the surgical resection, however, sBCC can be treated with more cost-effective noninvasive therapies such as 5% 5-Fluorouracil (5-FU). The objective of this study was to evaluate the clinical cure rate, tolerability and satisfaction levels on patients featured intermediate pigmented skin in the treatment of low-risk superficial basal cell carcinoma with topical 5% 5-FU. Methods: A prospective case series study was conducted between June 2014 and August 2018 at the dermatology service of Hospital de San José in Bogotá, Colombia with histologically-proven superficial BCC lesions. Lesions were treated with topical 5% 5-FU twice daily for up to 8 weeks. A follow-up evaluation was conducted at weeks four and eight during treatment. Follow-up was planned to be conducted every three months. Results: The study included 19 patients with 23 biopsy-proven sBCC lesions. Twenty-two lesions completed treatment with 5% 5-FU cream. The follow-up period ranged between 7 and 48 months and the median follow-up time was 38 months (IQR 21-48).  All study  patients featured intermediate or higher pigmented skin. Clinical cure was achieved in 95.45% of treated lesions. Conclusions: The efficacy rate of 5% 5-FU for 8 weeks treatment for sBCC located in intermediate and low-risk areas was 95% offering high levels of patient satisfaction with an outstanding tolerability profile.