Confocal microscopy-guided laser ablation for superficial and early nodular basal cell carcinoma: A promising surgical alternative for superficial skin cancers Journal Article

   


Authors: Chen, C. S. J.; Sierra, H.; Cordova, M.; Rajadhyaksha, M.
Article Title: Confocal microscopy-guided laser ablation for superficial and early nodular basal cell carcinoma: A promising surgical alternative for superficial skin cancers
Abstract: IMPORTANCE Laser ablation is a rapid and minimally invasive approach for the treatment of superficial skin cancers, but efficacy and reliability vary owing to lack of histologic margin control. High-resolution reflectance confocal microscopy (RCM) may offer a means for examining margins directly on the patient. OBSERVATIONS We report successful elimination of superficial and early nodular basal cell carcinoma (BCC) in 2 cases using RCM imaging to guide Er:YAG laser ablation. Three-dimensional (3D) mapping is feasible with RCM to delineate the lateral border and thickness of the tumor. Thus, the surgeon may deliver laser fluence and passes with localized control-ie, by varying the ablation parameters in sublesional areas with specificity that is governed by the 3D topography of the BCC. We further demonstrate intraoperative detection of residual BCC after initial laser ablation and complete removal of remaining tumor by additional passes. Both RCM imaging and histologic sections confirm the final clearance of BCC. CONCLUSIONS AND RELEVANCE Confocal microscopy may enhance the efficacy and reliability of laser tumor ablation. This report represents a new translational application for RCM imaging, which, when combined with an ablative laser, may one day provide an efficient and cost-effective treatment for BCC.
Keywords: diagnosis
Journal Title: JAMA Dermatology
Volume: 150
Issue: 9
ISSN: 2168-6068
Publisher: American Medical Association  
Date Published: 2014-09-01
Start Page: 994
End Page: 998
Language: English
ACCESSION: WOS:000345273800020
DOI: 10.1001/jamadermatol.2013.10225
PROVIDER: wos
PMCID: PMC4161660
PUBMED: 24827701
Notes: Article -- Source: Wos
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MSK Authors
  1. Chih-Shan Jason Chen
    55 Chen
  2. Milind Rajadhyaksha
    223 Rajadhyaksha
  3. Heidy Sierra Gil
    23 Sierra Gil
  4. Miguel A Cordova
    88 Cordova
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