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Surgery Beats Photodynamic Therapy for Basal Carcinoma

However, photodynamic therapy may be preferable to excision for cosmetic reasons in some cases

THURSDAY, Sept. 20 (HealthDay News) -- Although excision surgery for primary nodular basal cell carcinoma is associated with a lower recurrence than treatment with topical methyl aminolevulinate photodynamic therapy (PDT), the latter method offers benefits that make it more suitable in certain cases, according to the results of a randomized, prospective trial published in the September issue of the Archives of Dermatology.

Lesley E. Rhodes, M.D., of the University of Manchester and Salford Royal Foundation Hospital in Manchester, U.K., and colleagues analyzed data from a prospective, randomized study of 97 patients. Fifty patients had 53 lesions treated with methyl aminolevulinate PDT, and 47 patients had 52 lesions treated with excision surgery. Patients with a complete clinical response at three months were followed long-term.

After five years, 14 percent of the PDT lesions had recurred versus 4 percent of the surgery lesions. However, 87 percent of patients in the PDT group had "excellent" or "good" cosmetic results versus 54 percent in the surgery group.

"Whereas simple excision surgery will generally remain the treatment of choice for nodular basal cell carcinoma amenable to this intervention, methyl aminolevulinate PDT is also an effective treatment," the authors write. PDT "may be more suitable for the treatment of lesions in cosmetically sensitive areas, such as the face (involving approximately 50 percent of lesions in the present study), where optimal cosmetic outcome is an important clinical consideration."

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