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Laser Treatment for Non-Melanoma Skin Cancer: A Systematic Review and Meta-Analysis

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American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background

Surgery is the mainstay of treatment for non-melanoma skin cancer. Lasers are an additional option.

Objective

The objective of this study was to review the literature on the efficacy and safety of lasers for the treatment of non-melanoma skin cancer.

Methods

A systematic review and meta-analysis of laser treatment for non-melanoma skin cancer was performed. The primary outcome was recurrence rate (RR).

Results

The review included 32 studies (six randomized controlled trials and 26 cohort studies): 27 evaluated basal cell carcinomas (BCCs), three squamous cell carcinomas, and two both, for a total of 4755 BCCs and 214 squamous cell carcinoas. Most BCCs were low risk. The Nd:YAG laser (seven studies, 3286 BCCs) had a 3.1% RR (95% confidence interval [CI] 1.4–6.4%) during a mean follow-up of 7.9 years, with a low rate (< 20%) of scarring and dyspigmentation. The CO2 laser (ten studies, 904 BCCs) had a 9.4% RR (95% CI 4.1–20) during a mean follow-up of 2.1 years, with a low rate of side effects. The pulsed dye laser (eight studies, 206 BCCs) had a 38% RR (95% CI 24–55). In two studies, the Nd:YAG laser demonstrated a RR of 10% (95% CI 2–31) for Bowen’s disease, and in three studies, the CO2 laser demonstrated a RR of 22% (95% CI 5–61) for squamous cell carcinoma.

Conclusions

Based on cohort studies, the Nd:YAG laser is a safe and efficacious modality for the treatment of low-risk BCC. Based on settings applied in prior studies in the literature, the CO2 laser is less efficacious than the Nd:YAG laser, thus it cannot be recommended for BCC treatment. Insufficient data preclude conclusions regarding laser treatment for squamous cell carcinoma.

Registration

PROSPERO registration number CRD42019129717.

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Author information

Author notes

  1. Eran Sharon and Igor Snast contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Surgery, Breast Surgery Clinic, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel

    Eran Sharon

  2. Laser Unit, Division of Dermatology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 4941492, Israel

    Igor Snast, Moshe Lapidoth, Daniel Mimouni, Emmilia Hodak & Assi Levi

  3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Eran Sharon, Igor Snast, Moshe Lapidoth, Ran Kaftory, Daniel Mimouni, Emmilia Hodak & Assi Levi

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  1. Eran Sharon
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Contributions

ES., I.S., and A.L. were responsible for the data analysis and wrote the first draft of the manuscript. All co-authors contributed to the writing of the manuscript. All co-authors provided important intellectual input and approved the final version of the manuscript.

Corresponding author

Correspondence to Igor Snast.

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Funding

No external funding was used in the preparation of this article.

Conflicts of interest/competing interests

Eran Sharon, Igor Snast, Moshe Lapidoth, Ran Kaftory, Daniel Mimouni, Emmilia Hodak, and Assi Levi have no conflicts of interest that are directly relevant to the content of this article.

Ethics approval

No ethics approval was needed because data were retrieved from previously published studies in which informed consent was obtained by the primary investigators.

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Not applicable.

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Not applicable.

Availability of data and material

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Code availability

International Prospective Register of Systematic Reviews (PROSPERO), registration number: CRD42019129717.

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Sharon, E., Snast, I., Lapidoth, M. et al. Laser Treatment for Non-Melanoma Skin Cancer: A Systematic Review and Meta-Analysis. Am J Clin Dermatol 22, 25–38 (2021). https://doi.org/10.1007/s40257-020-00562-8

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  • DOI: https://doi.org/10.1007/s40257-020-00562-8

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