Prospective Clinical Trial Comparing Curettage and Cryosurgery to Curettage and Electrodesiccation in the Management of Minimally Invasive Basal and Squamous Cell Carcinomas

Abstract

Background Basal and squamous cell carcinomas represent the most common cancers in North America. Their management is an important issue. Objectives The evaluation of cure rates of minimally invasive cutaneous carcinomas with curettage-cryosurgery compared to curettage-electrodesiccation, as well as the assessment of the aesthetic appearance of scars. Methods This prospective trial randomized 117 patients 1:1 to treatments of curettage-cryosurgery or curettage-electrodesiccation. They were then followed at 6, 12, 18, and 24 months. Results At 12-month follow-up, only one (1/49) patient had a recurrence of cutaneous carcinoma in the curettage-cryosurgery group and none (0/43) in the curettage-electrodesiccation group. Farrington-Manning analysis with a 5% margin of error showed the non-inferiority of the first method ( P = .04). For the aesthetic appearance of scars after 12 months, better results with curettage-cryosurgery procedure has been observed, but this was not statistically significant ( P = .80 and P = .27 for evaluations of patients and clinicians respectively). Limitations This study was mainly limited by its small sample size. Conclusion We have demonstrated that curettage-cryosurgery compared to curettage-electrodesiccation for the treatment of minimally invasive carcinomas is noninferior (comparable) with regards to cure rates at 12-month follow-up. No significant difference has been demonstrated for the appearance of scars.