Basal cell carcinoma (BCC) is the most common skin cancer worldwide. Most occur on the head and neck, where cosmetic and functional outcomes are critical. BCC can be locally destructive if not diagnosed early and treated appropriately. Surgery is the treatment of choice for the majority of high-risk lesions. Aggressive, recurrent or unresectable tumors can be difficult to manage. Until recently, no approved systemic therapy was available for locally advanced or metastatic BCC inappropriate for surgery or radiotherapy. Vismodegib provides a systemic treatment option. However, a consensus definition of advanced BCC is lacking. A multidisciplinary panel with expertise in oncology, dermatology, dermatologic surgery and radiation oncology proposes a consensus definition based on published evidence and clinical experience.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Published online 16 February 2015

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Financial & competing interests disclosure

This project was supported by an unrestricted grant from Roche. K Peris, L Licitra, PA Ascierto, R Corvò, M Simonacci, F Picciotto, G Gualdi, G Pellacani and A Santoro have received honoraria from Roche for consultant/advisory activities. L Licitra has received honoraria also for a consultant/advisory role from Eisai, BMS, GSK, Merck Serono, Amgen, Boehringer Ingelheim, Debiopharm, VentiRX and SOBI; received research funds (for her institution) from Eisai, Merck Serono, Amgen and Boehringer Ingelheim; received travel expenses for medical meetings from Merck Serono and Debiopharm. PA Ascierto has received honoraria also for a consultant/advisory role from BMS, GSK and Novartis and received research funds from BMS. R Corvò has received honoraria also as a consultant for Therabel Gienne and received honoraria from M Serono. A Santoro has participated also on advisory boards for Bayer, Takeda, Daiichi, Arqule, GSK, Novartis, Ariad and received honoraria. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial assistance in the preparation of this manuscript was provided by R Vernell, an independent medical writer, on behalf of Springer Healthcare Communications. This assistance was funded by an unrestricted grant from Roche.

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