Perianal Basal Cell Carcinoma—A Systematic Review and Meta-Analysis of Real-World Data
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy and Study Selection
2.2. Data Extraction
2.3. Quality Assessment
2.4. Statistical Analysis
3. Results
3.1. Study Selection and Quality Assessment
3.2. Clinical Features of the Patients
3.3. Characteristics of Perianal BCC
3.4. Diagnosis of Perianal BCC
3.5. Treatment and Outcomes
4. Discussion
4.1. Epidemiology of Perianal BCCs
4.2. Etiology of Perianal BCCs
4.3. Characteristics and Diagnosis of Perianal BCC
4.4. Treatment and Outcomes of Perianal BCC
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Search Strategy
Embase | #1 ‘basal cell carcinoma’/exp OR ‘basal cell carcinoma’ |
#2 ‘perianal’ OR ‘anus’ | |
#3 ‘epithelioma’ | |
#4 ‘basal cell’ | |
#5 #1 AND #2 | |
#6 #2 AND #3 AND #4 | |
#7 #5 OR #6 | |
Medline (Clarivate Analytics) | (basal cell) AND (carcinoma or epithelioma) AND (perianal or anus or anal) |
PubMed | #1 ‘basal cell carcinoma’ |
#2 ‘perianal’ OR ‘anus’ | |
#3 ‘epithelioma’ | |
#4 ‘basal cell’ | |
#5 #1 AND #2 | |
#6 #2 AND #3 AND #4 | |
#7 #5 OR #6 |
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Year | Author | Sample Size | Study Type | Gender | Age/Mean or Median (Range) | Quality Score |
---|---|---|---|---|---|---|
1949 | Lott, B.D. [13] | 1 | Case report | F | 62 | 50% |
1954 | Klippel [14] | 1 | Case report | M | 65 | 50% |
1955 | Manheim, S.D. [15] | 1 | Case report | M | 72 | 50% |
1956 | Case, T.C. [16] | 1 | Case report | F | 72 | 63% |
1958 | Bunstock, W.H. [17] | 1 | Case report | M | 93 | 40% |
1958 | Hanley, P.H. [18] | 3 | Case report | 1M2F | 72, 68, 65 | 53% |
1958 | Rosenberg and Rosen [19] | 1 | Case report | F | 49 | 37% |
1966 | Turell, R. [20] | 1 | Case report | M | not reported | 53% |
1978 | Kraus [21] | 1 | Case report | F | 82 | 53% |
1981 | Baruchin [22] | 1 | Letter to the editor | F | 64 | 23% |
1992 | Espana, A. [23] | 1 | Case report | F | 72 | 47% |
1992 | Kyzer, S. [24] | 1 | Letter to the editor | F | 33 | 37% |
1995 | Kort [25] | 1 | Case report | M | 88 | 23% |
1996 | Alvarez-Cañas [26] | 5 | Case report | 1M4F | 62.8 (36–84) | 53% |
2001 | Karim, R. [27] | 1 | Case report | M | 83 | 53% |
2002 | Damin, D.C. [28] | 1 | Case report | F | 77 | 47% |
2003 | Ruiz-de-Erenchun, R. [29] | 1 | Letter to the editor | M | 90 | 33% |
2004 | Misago, N. [30] | 1 | Case report | F | 88 | 53% |
2010 | Naidu, N. [31] | 1 | Case report | M | 69 | 60% |
2010 | Shaikh, F.M. [32] | 1 | Image challenge | M | 72 | 43% |
2012 | Kreuter, A. [33] | 1 | Case report | M | 88 | 53% |
2012 | Lohana, P. [34] | 1 | Case report | M | 58 | 53% |
2012 | Oliphant, T. [35] | 1 | Conference abstract | F | 82 | 43% |
2012 | Yasar, S [36] | 1 | Case report | F | 50 | 53% |
2013 | Kahn, S. [37] | 1 | Case report | F | 62 | 53% |
2013 | Ng, K.-S. [38] | 1 | Case report | M | 80 | 33% |
2015 | Bulur, I. [39] | 1 | Case report | M | 34 | 60% |
2015 | Lee, H.S. [40] | 1 | Letter to the editor | M | 83 | 50% |
2016 | Rivera-Chavarrí [41] | 1 | Case report | F | 93 | 73% |
2018 | Carr, A.V. [42] | 1 | Case report | M | 66 | 80% |
2019 | Aldana, P.C. [43] | 1 | Case report | M | 89 | 53% |
2019 | Meeks, M. [44] | 1 | Case report | M | 49 | 50% |
2020 | Hagen, E.R. [45] | 1 | Case report | M | 67 | 57% |
2020 | Sharma, S. [46] | 1 | Conference abstract | F | 73 | 43% |
2021 | Imbernon-Moya, A. [47] | 1 | Case report | F | 68 | 43% |
2022 | Lim, M.G. [48] | 1 | Case report | F | 60 | 70% |
2022 | Tung, J. [49] | 1 | Case report | M | 69 | 90% |
1981 | Nielsen, O.V. [50] | 34 | Retrospective study | 18M16F | 68 (43–86) | 64% |
1999 | Paterson, C.A. [51] | 19 | Retrospective study | 15M4F | 67(43–81) | 64% |
2001 | Gibson [7] | 15 | Retrospective study | 9M6F | 73(45–100) | 64% |
2021 | Liu, S. [52] | 29 | Retrospective study | 23M6F | 70 (43–90) | 73% |
Mean | |
---|---|
Age at diagnosis (n = 124) | 68.8 ± 8.9 |
Gender (n = 140) | |
Male | 86 (61.4) |
Female | 54 (38.6) |
Clinical presentation at diagnosis | Reported cases (% out of 70) |
No symptoms | 9 (12.9) |
Pain | 21 (30.0) |
Bleeding | 24 (24.3) |
Pruritus | 13 (18.6) |
Change in bowel habits | 9 (12.9) |
Anal discharge | 3 (4.3) |
History of BCCs at other anastomotic sites | Reported cases (% out of 70) |
Yes | 19 (27.1) |
No | 51 (72.9) |
History of other anal diseases | Reported cases (% out of 70) |
Yes | 6 (8.6) |
No | 64 (91.4) |
Tumor Morphology | n (% Out of 42) |
---|---|
Polypoid/Nodular | 2 (4.8) |
Pedunculated | 1 (2.4) |
Induration | 6 (14.3) |
Ulceration | 28 (66.7) |
Fungating | 4 (9.5) |
Raised edge | 16 (38.1) |
Hyper-/Hypopigmentation | 13 (31.0) |
Tumor size | n (% out of 37) |
≤20 mm | 10 (27.0) |
>20 mm to ≤40 mm | 14 (37.8) |
>40 mm | 13 (35.1) |
Tumor stage | n (% out of 37) |
Stage I | 10 (27.0) |
Stage II | 13 (35.1) |
Stage III | 14 (37.8) |
Stage IV | 0 (0) |
Tumor location | n (% of 69) |
Anterior | 5 (7.2) |
Right anterior | 3 (4.3) |
Right | 9 (13.0) |
Right posterior | 3 (4.3) |
Posterior | 19 (27.5) |
Left posterior | 1 (1.4) |
Left | 26 (37.7) |
Left anterior | 1 (1.4) |
Circumferential | 2 (2.9) |
Sphincter invasion | n (% of 140) |
Yes | 4 (2.9) |
No | 30 (21.4) |
Not reported | 106 (75.7) |
Studies | Case Number | Treatment | Follow Up Times | Outcomes |
---|---|---|---|---|
Nielsen, O.V., 1981 [50] | 34 | Local excisions (n = 27) APR (n = 4) Colostomy (n = 1) | Not reported | Five-year OS 72.6%. Eight (23%) patients had a recurrence after local excision. One patient had an inguinal recurrence. Sixteen mortalities of other causes. |
Paterson C.A., 1999 [51] | 19 | Local excisions (n = 17) Mohs microsurgery (n = 1) Electrodesiccation (n = 1) | 72 months (2–214) | No recurrence. Four mortalities of other causes. |
Gibson, 2001 [7] | 51 (15 perianal, 36 genital) | Wide excision (n = 32) Electrodesiccation and curettage (n = 10), Mohs micrographic surgery (n = 8) Carbon dioxide laser (n = 1) | 5 years or more | One recurrence of a superficial BCC of the vulva. |
Liu, S., 2021 [52] | 29 | Local excisions (n = 29) | 5.5 ± 4.6 years | No recurrence. No mortality. |
n | Recurrence | p Value | |
---|---|---|---|
Radiation therapy only | 5 | 0 | 0.94 |
Radiation therapy followed by cryotherapy | 1 | 0 | |
Electrodesiccation | 1 | 0 | |
Local excision only | 102 | 8 | |
Local excision plus adjuvant RT | 4 | ||
Radiation therapy followed by Mohs microscopic surgery | 1 | 0 | |
Mohs microscopic surgery | 3 | 0 | |
Radiation therapy followed by APR | 1 | 0 | |
APR | 5 | 0 | |
Others | 2 | 0 |
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Tsai, T.-Y.; Liao, C.-K.; Zhang, B.-Y.; Huang, Y.-L.; Tsai, W.-S.; You, J.-F.; Yeh, C.-Y.; Hsieh, P.-S. Perianal Basal Cell Carcinoma—A Systematic Review and Meta-Analysis of Real-World Data. Diagnostics 2023, 13, 1650. https://doi.org/10.3390/diagnostics13091650
Tsai T-Y, Liao C-K, Zhang B-Y, Huang Y-L, Tsai W-S, You J-F, Yeh C-Y, Hsieh P-S. Perianal Basal Cell Carcinoma—A Systematic Review and Meta-Analysis of Real-World Data. Diagnostics. 2023; 13(9):1650. https://doi.org/10.3390/diagnostics13091650
Chicago/Turabian StyleTsai, Tzong-Yun, Chun-Kai Liao, Bang-Yan Zhang, Yen-Lin Huang, Wen-Sy Tsai, Jeng-Fu You, Chien-Yuh Yeh, and Pao-Shiu Hsieh. 2023. "Perianal Basal Cell Carcinoma—A Systematic Review and Meta-Analysis of Real-World Data" Diagnostics 13, no. 9: 1650. https://doi.org/10.3390/diagnostics13091650