Basal cell carcinoma of skin
ICD-10 C44.9 · ICD-11 2C32

Treatment of Recurrent, High-Risk, or Complex Basal Cell Carcinoma

Certain presentations of basal cell carcinoma of the skin carry a higher risk of treatment failure or significant morbidity, requiring more careful management than straightforward primary disease. This protocol addresses those higher-risk scenarios.

Clinical scenario — high-risk features
  • Recurrent basal cell carcinoma
  • Aggressive histopathological subtype
  • Location on a critical anatomical site
  • Poorly defined tumour margins
  • Perineural invasion
  • Multiple basal cell carcinomas
Treatment approach

When surgery or radiotherapy are not feasible or are contraindicated, an electrochemotherapy-based approach may be offered — using a chemotherapeutic agent delivered via high-voltage electrical pulses to enhance intracellular uptake.

The full regimen, sequencing, and criteria for use are detailed in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.ejca.2023.113254

Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites.

Micrographically controlled surgery (3D) shall be offered in high-risk BCC (recurrent, aggressive subtypes, location in critical anatomical sites, poorly defined margins).

ECT is a treatment option that may be offered when surgery or radiotherapy are not feasible or contraindicated.

ECT provides its antitumor effect through the permeabilisation of cancer cells to chemotherapeutic agents (bleomycin or cisplatin) by means of short, high-voltage, electric pulses which destabilise the cell membrane barrier allowing their intracellular access.

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