Basal Cell Carcinoma: Impact of Location of Metastasis on Survival Outcomes

By: Victoria Kuhr, MS
Posted: Wednesday, February 14, 2024

Patients with nodal metastatic basal cell carcinoma appear to be more likely to have disease remission than patients with distant metastatic basal cell carcinoma, who seem to experience more persistent disease progression and disease-related death, according to a multicenter study published in the Journal of the American Academy of Dermatology. Emily S. Ruiz, MD, MPH, of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues reported the 5-year survival rate of patients with nodal and distant metastatic basal cell carcinomas exceeded 50%, even for late-stage disease.

This retrospective cohort study recruited patients with metastatic basal cell carcinoma who were treated at four large academic centers in Boston, Philadelphia, and Cleveland between January 2005 and December 2021. The study analyzed patient and tumor characteristics stratified by location of metastasis. Additionally, the follow-up time was recorded from diagnosis to the last appointment with a health-care provider or patient death.

Almost half of the metastatic tumors originated in the head and neck region (nodal metastasis: 10; distant metastasis: 15). The remainder of the tumors originated in the trunk (nodal metastasis: 5; distant metastasis: 11); extremities (nodal metastasis: 3; distant metastasis: 1); or an unknown primary region (nodal metastasis: 4; distant metastasis: 4).

A total of 53 patients were included in the study’s analysis. Of them, 22 (42%) had metastatic basal cell carcinoma with limited spread to the lymph nodes, and 31 (58%) had metastatic basal cell carcinoma that spread to other organs (with or without lymph node involvement). Overall, 16 patients (52%) who had basal cell carcinoma with nodal metastasis achieved complete remission of the disease, compared with 1 patient (3%) who had basal cell carcinoma with distant metastasis. The researchers observed that treatments chosen and responses to therapy did not seem to differ between the two types of metastatic location based on the primary tumor location. The 5-year survival rates for patients with nodal and distant metastatic basal cell cancers were 89.3% and 61.0%, respectively.

Disclosure: For full disclosures of the study authors, visit jaad.org.

Journal of the American Academy of Dermatology