COMBINING clinical and dermoscopic examination (CDE) with optical coherence tomography (OCT) significantly improves detection of residual and recurrent superficial basal cell carcinoma (BCC), following topical treatment, according to new research.
Superficial BCC is a type of skin cancer that can be treated topically. Follow-up after treatment involves CDE; however, residual or recurrent disease may not be detected by CDE alone. To investigate this further, Tom Wolswijk, Department of Dermatology, Maastricht University Medical Center+, the Netherlands, and GROW Research Institute for Oncology and Reproduction, Maastricht University, the Netherlands, and colleagues performed a diagnostic cohort study enrolling 100 patients with superficial BCC treated with topical therapy. They conducted this to evaluate the diagnostic accuracy of CDE alone compared with CDE plus OCT in identifying residual or recurrent BCC. Of the 100 patients included, 20 had a histopathological diagnosis of residual or recurrent BCC.
When evaluating diagnostic accuracy, the authors found that the detection sensitivity for CDE alone was 60%, whereas it was 100% for CDE plus OCT. The difference was statistically significant with a p value of 0.005. While sensitivity was markedly improved using CDE plus OCT, specificity was similar for both CDE alone (96.3%) and CDE plus OCT (95.0%). Furthermore, CDE plus OCT had a negative predictive value of 100.0% compared with 90.6% for CDE alone (p=0.005), and the area under the curve was significantly higher (p=0.001) for CDE plus OCT (0.98) compared with CDE alone (0.77).
The findings from this study are of interest since residual or recurrent superficial BCC following topical treatment may not be visible on CDE. However, these results suggest that CDE plus OCT yields a significantly higher detection of residual or recurrent BCC after topical treatment for superficial BCC. It is important to note that the sample size was small, and further evaluation in larger studies will provide more comprehensive insights.