A randomised controlled trial of excisional surgery versus imiquimod 5% cream for nodular and superficial basal cell carcinoma.

This is an independent study (a randomised controlled trial) of imiquimod cream versus surgery in low risk basal cell carcinoma (or "rodent ulcer"). Basal cell carcinoma (BCC) is the commonest cancer in humans. BCCs are slow growing and rarely spread to other sites of the body, but can be unsightly and can bleed. They are usually treated by minor surgery (current “gold standard”) or freezing with liquid nitrogen, but dermatologists and plastic surgeons are constantly on the look-out for other simple but effective treatments. Imiquimod 5% cream stimulates the body's immune system and has been used successfully to treat genital warts, and more recently BCCs. This is a large definitive study comparing imiquimod to local surgery. Studies previous to this study were smaller, often looking just at initial success rather than whether the BCC returns in the long term. This study aims to show how effective imiquimod is in terms of percentage cure of basal cell carcinoma, three years after treatment, when compared with conventional surgery, and whether the cosmetic result of a cream that patients can apply themselves is any better than surgery.