Superficial Curettage May Not Be Noninferior to Excision for Nodular BCC
Researchers could not conclude that superficial curettage plus imiquimod is noninferior to surgical excision at five years after treatment
By Dermsquared Editorial Team | January 29, 2025
WEDNESDAY, Jan. 29, 2025 -- For patients with nodular basal cell carcinoma (nBCC), it cannot be concluded that superficial curettage (SC) plus imiquimod cream, 5 percent, is noninferior to surgical excision (SE) after five years of treatment, according to a study published online Jan. 29 in JAMA Dermatology.
Babette J.A. Verkouteren, M.D., Ph.D., from Maastricht University Medical Centre in the Netherlands, and colleagues conducted a secondary analysis of a noninferiority trial to examine whether SC followed by imiquimod cream, 5 percent, is noninferior to SE in nBCC after five years of treatment. Patients with a primary nBCC of 4 to 20 mm were assigned to either SC plus imiquimod, 5 percent, or SE (73 and 72 patients, respectively) between Jan. 1, 2016, and Nov. 30, 2017.
The researchers found 15 treatment failures in the SC plus imiquimod group and one treatment failure in the SE group. The five-year probability of remaining free from treatment failure was 77.8 and 98.2 percent after SC plus imiquimod and SE, respectively. The relative risk for treatment failure was 15.93 (95 percent confidence interval, 2.10 to 120.64); the 95 percent confidence interval did not exclude the noninferiority margin of 5.22.
"The information in this trial can be used to counsel patients on the relative benefits and trade-offs of the different treatment options for nBCC," the authors write.
Two authors disclosed ties to the pharmaceutical industry.