Basal Cell Skin Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Bichakjian, Christopher K.; Olencki, Thomas; Aasi, Sumaira Z.; Alam, Murad; Andersen, James S.; Berg, Daniel; Bowen, Glen M.; Cheney, Richard T.; Daniels, Gregory A.; Glass, L. Frank; Grekin, Roy C.; Grossman, Kenneth; Higgins, Susan A.; Ho, Alan L.; Lewis, Karl D.; Lydiatt, Daniel D.; Nehal, Kishwer S.; Nghiem, Paul; Olsen, Elise A.; Schmults, Chrysalyne D.; Sekulic, Aleksandar; Shaha, Ashok R.; Thorstad, Wade L.; Tuli, Malika; Urist, Marshall M.; Wang, Timothy S.; Wong, Sandra L.; Zic, John A.; Hoffmann, Karin G.; Engh, Anita

doi:10.6004/jnccn.2016.0065

Cited by 275Nonmelanoma Skin Cancer StudiesHedgehog Signaling Pathway StudiesCancer and Skin Lesions

Basal Cell Skin Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

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Bichakjian, Christopher K., Olencki, Thomas, Aasi, Sumaira Z., Alam, Murad, Andersen, James S., Berg, Daniel, Bowen, Glen M., Cheney, Richard T. +22 more·2016·Journal of the National Comprehensive Cancer Network

DOI 10.6004/jnccn.2016.0065

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Abstract

Basal cell carcinoma (BCC) of the skin is the most common cancer, with a higher incidence than all other malignancies combined. Although it is rare to metastasize, patients with multiple or frequently recurring BCC can suffer substantial comorbidity and be difficult to manage. Assessment of risk is a key element of management needed to inform treatment selection. The overall management of BCC primarily consists of surgical approaches, with radiation therapy as an alternate or adjuvant option. Many superficial therapies for BCC have been explored and continue to be developed, including topicals, cryosurgery, and photodynamic therapy. Two hedgehog pathway inhibitors were recently approved by the FDA for systemic treatment of advanced and metastatic BCC, and others are in development. The NCCN Guidelines for Basal Cell Skin Cancer, published in full herein, include recommendations for selecting among the various surgical approaches based on patient-, lesion-, and disease-specific factors, as well as guidance on when to use radiation therapy, superficial therapies, and hedgehog pathway inhibitors.

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Several guidelines indicate Mohs micrographic surgery as the first-choice treatment for cutaneous carcinomas at the ear.
“several guidelines indicate Mohs micrographic surgery (MMS) as the first-choice treatment for cutaneous carcinomas at this site.2, 3, 4”
From Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases (2021) · cites this paper as [3]
The BCC-A section lists the ear as a high-risk site, and “Mohs Micrographic Surgery or Excision With Intraoperative Frozen Section Assessment” calls MMS the preferred surgical technique for high-risk basal cell carcinoma. The claim extends that recommendation to cutaneous carcinomas generally, while this guideline addresses basal cell carcinoma; its primary-treatment pathway (BCC-3) also lists standard excision as an option, so MMS is not presented as the sole first-choice treatment. (LLM, conf=0.87)
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Authors: Bichakjian, C. K., Olencki, T., Aasi, S. Z., Alam, M., Andersen, J. S., Berg, D., Bowen, G. M., Cheney, R. T., Daniels, G. A., Glass, L. F., Grekin, R. C., Grossman, K., Higgins, S. A., Ho, A. L., Lewis, K. D., Lydiatt, D. D., Nehal, K. S., Nghiem, P., Olsen, E. A., Schmults, C. D., Sekulic, A., Shaha, A. R., Thorstad, W. L., Tuli, M., Urist, M. M., Wang, T. S., Wong, S. L., Zic, J. A., Hoffmann, K. G., & Engh, A.
Affiliations: University of Michigan (US)
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
Northwestern University (US)
Seattle Cancer Care Alliance (US)
University of Utah (US)
Roswell Park Comprehensive Cancer Center (US)
University of South Florida (US)
University of California, San Francisco (US)
Memorial Sloan Kettering Cancer Center (US)
University of Colorado Cancer Center (US)
St. Jude Children's Research Hospital (US)
ORCID: Bichakjian, Christopher K.
Aasi, Sumaira Z.
Alam, Murad
Berg, Daniel
Daniels, Gregory A.
Grekin, Roy C.
Ho, Alan L.
Lewis, Karl D.
Nehal, Kishwer S.
Nghiem, Paul
Olsen, Elise A.
Schmults, Chrysalyne D.
Shaha, Ashok R.
Thorstad, Wade L.
Urist, Marshall M.
Wong, Sandra L.
Hoffmann, Karin G.
Engh, Anita
Venue: Journal of the National Comprehensive Cancer Network
Publisher: Harborside Press, LLC
Published: 2016-05
Volume: 14
Issue: 5
Pages: 574-597
ISSN: 1540-1405 (ISSN-L)
1540-1413
DOI: 10.6004/jnccn.2016.0065
OpenAlex: W2389343900
Cited by: 275
References: 231
Citations by year: 2026: 7 · 2025: 14 · 2024: 23 · 2023: 33 · 2022: 37 · 2021: 44 · 2020: 32 · 2019: 38 · 2018: 30 · 2017: 11 · 2016: 4 · 2015: 1
FWCI: 25.90
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of the National Comprehensive Cancer Network (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Hedgehog Signaling Pathway Studies
Health Sciences › Medicine › Dermatology › Cancer and Skin Lesions
Keywords: basal cell carcinoma, skin cancer, surgical excision, radiotherapy, cryosurgery, photodynamic therapy, topical treatment, Hedgehog pathway inhibitors, metastatic basal cell carcinoma, recurrence, risk assessment, treatment selection
MeSH terms: Basal Cell Carcinoma, Humans, Skin Neoplasms, United States

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