van Winden MEC, Hetterschijt CRM, Bronkhorst EM, et al. - Findings indicate that watchful waiting (WW) might afford an appropriate strategy in basal cell carcinoma (BCC) cases with a limited life expectancy and asymptomatic nodular or superficial BCCs.

• An observational cohort study of 280 BCCs in 89 patients in the Netherlands, to assess reasons for WW and the natural course of BCC in patients who chose WW and reasons to initiate later treatment.

• The most important reasons to choose watchful waiting were: patient-related factors (eg, limited life expectancy or frailty), and for 35% and 46% of the patients, treatment-related and circumstantial reasons were important, respectively.

• Increase in size was evident in a minority of tumors (47%); tumor diameter increase was estimated to be 4.46 mm in 1 year for infiltrative/micronodular BCCs whereas it was 1.06 mm for nodular, superficial, or clinical BCCs.

• Most frequent causes to start treatment included tumor burden or potential tumor burden, resolved reason(s) for WW, and reassessment of patient-related factors.