Clinical and Histological Predictors of Advanced Basal Cell Carcinoma Recurrence After Complete Response to Hedgehog Pathway Inhibitors: A Retrospective Multicenter Observational Study.

/: Long-term outcome data of locally advanced basal cell carcinoma patients who achieve complete response (CR) on hedgehog pathway inhibitors (HHIs) are lacking, highlighting a gap in the identification of the predictors of tumor recurrence. We aimed to investigate the clinical and histological factors associated with locally advanced BCC recurrence after CR on HHIs. : We performed a retrospective multicenter observational study at 14 Italian tertiary referral centers (1 January 2016-1 March 2024). Univariate logistic regression was used to investigate the association between locally advanced BCC recurrence and clinical and histological features. Kaplan-Meier analysis was used to estimate relapse-free survival (RFS). : A total of 106 locally advanced BCC patients were enrolled, of whom 14/106 (13.2%) experienced relapse after a median follow-up of 12 months (range: 1-70 months). Low-risk locally advanced BCC histological subtypes (superficial and nodular) were associated with a decreased probability of locally advanced BCC recurrence (odds ratio [OR]: 0.15, 95% CI: 0.04-0.51; : 0.003); a longer time to CR predicted locally advanced BCC relapse (OR: 1.07, 95% CI: 1.01-1.15; : 0.04). Accordingly, locally advanced BCC histology and time to CR significantly impacted RFS probability. : Specific locally advanced BCC histological subtypes and time to CR predict tumor recurrence after CR on HHIs.