Presurgical mapping of basal cell carcinoma or squamous cell carcinoma by confocal laser endomicroscopy compared to traditional micrographic surgery: a single-centre prospective feasibility study

Eur J Dermatol. 2016 Dec 1;26(6):572-579. doi: 10.1684/ejd.2016.2874.

Abstract

Background: At present, no ideal diagnostic tools exist in the market to excise cancer tissue with the required safety margins and to achieve optimal aesthetic results using tissue-conserving techniques.

Objectives: In this prospective study, confocal laser endomicroscopy (CLE) and the traditional gold standard of magnifying glasses (MG) were compared regarding the boundaries of in vivo basal cell carcinoma and squamous cell carcinoma.

Materials & methods: Tumour diameters defined by both methods were measured and compared with those determined by histopathological examination. Nineteen patients were included in the study.

Results: The CLE technique was found to be superior to excisional margins based on MG only. Re-excision was required in 68% of the cases following excision based on MG evaluation, but only in 27% of the cases for whom excision margins were based on CLE.

Conclusion: Our results are promising regarding the distinction between tumour and healthy surrounding tissue, and indicate that presurgical mapping of basal cell carcinoma and squamous cell carcinoma is possible. The tool itself should be developed further with special attention to early detection of skin cancer.

Keywords: basal cell carcinoma; confocal laser endomicroscopy; magnifying glass; squamous cell carcinoma.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Basal Cell / diagnostic imaging*
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / surgery*
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Intravital Microscopy / methods
  • Male
  • Margins of Excision*
  • Microscopy, Confocal / methods
  • Middle Aged
  • Preoperative Period
  • Prospective Studies
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Tumor Burden