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Kamimura A, Nakamura Y, Takenouchi T, Matsushita S, Omodaka T, Yamamura K, Uchi H, Yoshikawa S, Yanagisawa H, Ito T, Kiyohara Y, Nakamura Y, Aoki M, Ishizuki S, Oashi K, Miyagawa T, Maeda T, Ogata D, Hatta N, Ohe S, Isei T, Takahashi A, Umeda Y, Yamaguchi B, Ishikawa M, Horimoto K, Fujsawa Y, Uehara J, Shibayama Y, Kiniwa Y, Kawahara Y, Matsuya T, Uhara H, Kato J, Nakamura Y, Murakami T, Namikawa K, Yoshino K, Funakoshi T, Takatsuka S, Matsui Y, Sasaki J, Koga H, Yokota K, Komori T, Fukushima S, Yamazaki N. Concordance in judgment of clinical borders of basal cell carcinomas in Japanese patients: A preliminary study of JCOG2005 (J-BASE-MARGIN). J Dermatol 2022; 49:837-844. [PMID: 35510662 DOI: 10.1111/1346-8138.16422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/07/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
Basal cell carcinoma is the most common type of skin cancer, and surgical excision with clear margins is the standard of care. Surgical margins are determined based on risk factors (high or low risk) for recurrence according to the National Comprehensive Cancer Network and Japanese basal cell carcinoma guidelines. The clarity of the clinical tumor border (well-defined or poorly defined) is considered a risk factor, and significant discrepancies in the judgment of clinical tumor borders among dermato-oncologists may occur. Therefore, we analyzed the dermato-oncologists' concordance in judging the clinical tumor border of basal cell carcinoma. Forty-seven dermato-oncologists (experts: 37; young trainees: 10) participated in this study. The datasets of clinical and dermoscopic photographs of 79 Japanese cases of head and neck basal cell carcinoma were used to determine the concordance in the judgment of clinical tumor border. The probability of the border that was selected more often was used to calculate the rater agreement rate for each dataset. Correct judgment was defined as a more frequently selected border, and the concordance rate of clarity of clinical tumor border for each dermato-oncologist was calculated based on the definition of the correct judgment. A median concordance rate of 85% or higher for all dermato-oncologists was predefined as an acceptable rate for clinical use. Of the 79 datasets, rater agreement rates were 80-100%, 60-79%, and 51-59% for 55, 19, and five datasets, respectively. The median concordance rate for all dermato-oncologists was 86% (interquartile range: 82-89%). There was no significant difference in the concordance rate between the experts and the trainees (median, 87% vs. 85.5%; p = 0.58). The concordance rates of dermato-oncologists for all datasets were relatively high and acceptable for clinical use.
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Affiliation(s)
- Anna Kamimura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | | | - Shigeto Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | | | - Kentaro Yamamura
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Hiroshi Uchi
- Department of Dermatologic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Hiroto Yanagisawa
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Takamichi Ito
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - Yoshio Kiyohara
- Dermatology Division, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Megumi Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shoichiro Ishizuki
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kohei Oashi
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Takuya Miyagawa
- Department of Dermatology, University of Tokyo, Tokyo, Japan
| | - Taku Maeda
- Department of Plastic and Reconstructive Surgery, Hokkaido University, Sapporo, Japan
| | - Dai Ogata
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naohito Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Shuichi Ohe
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Taiki Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Takahashi
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiyasu Umeda
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Buntaro Yamaguchi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masashi Ishikawa
- Department of Dermatology, Saitama Cancer Center, Saitama, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yasuhiro Fujsawa
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jiro Uehara
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Yukiko Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Yu Kawahara
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Taisuke Matsuya
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Junji Kato
- Department of Dermatology, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yoshiyuki Nakamura
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takuo Murakami
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Kenjiro Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Yoshino
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | | | - Sumiko Takatsuka
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Yu Matsui
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Jin Sasaki
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - Hiroshi Koga
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - Kenji Yokota
- Department of Dermatology, Nagoya University, Nagoya, Japan
| | - Takaya Komori
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoya Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
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