D‐OCT‐assisted and Histology‐controlled Evaluation of 1064 Nm Nd:YAG Laser Therapy of Basal Cell Carcinomas

Background: Basal cell carcinomas (BCC) have classically been surgically removed. Alternative treatments for superficial BCC include local immunotherapy, topical chemotherapy and photodynamic therapy. Recent data suggest 1064 nm Nd:YAG laser as a new treatment for those lesions. Dynamic optical coherence tomography (D-OCT) is an established imaging procedure analysing BCC margins and its vascular plexus. Objectives: Our goal is to further evaluate 1064 nm Nd:YAG laser therapy of BCC as a potential alternative treatment, employing D-OCT and histopathology to standardise effective treatment protocols. Methods: In this retrospective cohort study, 50 histologically confirmed superficial and nodular BCC with tumour thickness <= 1 mm were treated with 1064 nm Nd:YAG laser. Initial D-OCT scans were performed and repeated for 3 months posttreatment. Tumoral clearance was histologically confirmed and local adverse effects, patient tolerability and satisfaction were recorded. Clinical remission was evaluated after 1 year. Results: Complete clearance was achieved in 78% of BCC (39/50) at a 3-month follow-up. Treatment failures were slightly more likely to correspond to superficial BCC (91%, 10/11) of thickness <= 0.5 mm (73%, 8/11), located on the trunk (64%, 7/11). No treated lesions presented scarring. Patient satisfaction and tolerability displayed excellent results. Remission at 1 year occurred in 100% of initially cleared BCC (35/35, four patients were lost to follow-up due to nonmedical reasons). Conclusions: OCT-assisted 1064 nm Nd:YAG laser treatment of superficial BCC is a safe and effective method with excellent patient satisfaction, tolerability, practicability and cosmetic end result.