Surgery for Squamous Cell Carcinoma Reduced With Fluorouracil Cream

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During the first year, 1% and 4% of patients in the fluorouracil and control groups developed a squamous cell carcinoma.
During the first year, 1% and 4% of patients in the fluorouracil and control groups developed a squamous cell carcinoma.

HealthDay News — Fluorouracil application can reduce the risk of surgery for squamous cell carcinoma for 1 year among patients with a history of keratinocyte carcinomas, according to a study published online in JAMA Dermatology.

Martin A. Weinstock, MD, PhD, from the Veterans Affairs Medical Center in Providence, RI, and colleagues randomized 932 veterans with a history of at least 2 keratinocyte carcinomas in the past 5 years to applications of fluorouracil, 5% (468 patients), or vehicle control cream (464 patients) to the face and ears twice daily for 2 to 4 weeks.

The researchers found that over 4 years, 299 patients developed a basal cell carcinoma end point and 108 developed a squamous cell carcinoma end point. There was no difference between the treatment groups in the time to first keratinocyte, basal cell, or squamous cell carcinoma over the entire study.

During the first year, 1% and 4% of patients in the fluorouracil and control groups developed a squamous cell carcinoma, respectively (75% risk reduction; 95% CI, 35% to 91%; P =.002). The 11% reduction in basal cell carcinoma risk during the first year in the fluorouracil group was not significant, and there was not a significant effect on keratinocyte carcinoma risk.

"A conventional course of fluorouracil to the face and ears substantially reduces surgery for squamous cell carcinoma 1 one year," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

Reference

Weinstock MA, Thwin SS, Siegel JA, et al. Chemoprevention of basal and squamous cell carcinoma with a single course of fluorouracil, 5%, cream: a randomized clinical trial [published online January 3, 2018]. JAMA Dermatol. doi: 10.1001/jamadermatol.2017.3631

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