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Soo Park, MD
Soo Park, MD
Posted: Monday, April 21, 2025
A secondary long-term analysis of a randomized clinical trial published in JAMA Dermatology verified that superficial curettage followed by imiquimod cream (5%) cannot be considered noninferior to standard surgical excision for patients with nodular basal cell carcinoma (BCC). Additionally, superficial curettage plus imiquimod proved less effective than surgical excision at 5 years after treatment, investigators reported.
The noninferiority Surgery Versus Combined Treatment With Curettage and Imiquimod for Nodular Basal Cell Carcinoma (SCIN) randomized clinical trial randomly assigned 145 patients in the Netherlands with primary nodal BCC measuring between 4 mm and 20 mm to undergo either superficial curettage followed by imiquimod cream (5%) or surgical excision. The primary endpoint was the 1-year probability of remaining free from treatment failure. A prespecified secondary analysis was completed after 5 years of follow-up.
The 5-year treatment failure–free rate was 77.8% (95% confidence interval [CI] = 65.7%–86.0%) in the superficial curettage plus imiquimod arm compared with a rate of 98.2% (95% CI = 88.0%–99.8%) in the surgical excision arm (relative risk = 15.93; 95% CI = 2.10–120.64). The prespecified noninferiority relative risk margin of 5.22 was within this confidence interval. Also of note, most treatment failures occurred within the first year.
“The information in this trial can be used to counsel patients on the relative benefits and trade-offs of the different treatment options for nodal BCC,” the study authors, led by Babette J. A. Verkouteren, MD, PhD, of the Department of Dermatology, Maastricht University Medical Centre, Maastricht, the Netherlands, concluded in their report.
Disclosure: The study authors reported no conflicts of interest.
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