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Management of periocular basal and squamous cell carcinoma: a series of 485 cases.
Am J Ophthalmol. 2006 Aug; 142(2):293-7.AJ

Abstract

PURPOSE

To analyze the outcome of management of patients with basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) in a tertiary referral eye center in Sydney, Australia.

DESIGN

Retrospective case series.

METHODS

Review of medical records of 485 consecutive cases (469 patients) with confirmed eyelid cancer. Intervention procedures: Surgical excision with 3- to 5-mm clinically clear margins and histologic confirmation of the surgical margins. Frozen section histology or Mohs' micrographic surgery (MMS) was used for incompletely excised cases, and those located in the medial canthus or close to the lacrimal drainage system. Standard reconstruction techniques were employed.

MAIN OUTCOME MEASURES

Survival period free of tumor, incomplete excision, recurrences, type of closure, and complications.

RESULTS

Excision was initially incomplete in 25.4% of all tumors. Morpheaform type of BCC (chi(2)P < .001), and medial canthus location BCCs (chi(2)P < .05) were associated with a higher incomplete resection rate. A 35.9% incomplete excision rate was associated with a significantly higher recurrence rate compared with complete excision (8.4% and 4.6%, respectively, chi(2)P < .05). Twenty-seven patients (5.6%) had a recurrent tumor. After incomplete excision, there was no recurrence with MMS, but 4.7% recurrence rate when frozen section technique was used (P < .05). Local postoperative complications occurred in 41 patients (8.5%).

CONCLUSIONS

In the setting of a tertiary referral center, incomplete primary resection of an eyelid skin cancer is the main risk factor for recurrence. Incomplete resection is significantly associated with medial canthus location and morpheaform type of BCC and with moderately differentiated SCC. MMS is the safer technique after incomplete tumor excision.

Authors+Show Affiliations

Oculoplastic Unit, Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Macquarie Street, Sydney, NSW, Australia. nemeta@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16876511

Citation

Nemet, Arie Y., et al. "Management of Periocular Basal and Squamous Cell Carcinoma: a Series of 485 Cases." American Journal of Ophthalmology, vol. 142, no. 2, 2006, pp. 293-7.
Nemet AY, Deckel Y, Martin PA, et al. Management of periocular basal and squamous cell carcinoma: a series of 485 cases. Am J Ophthalmol. 2006;142(2):293-7.
Nemet, A. Y., Deckel, Y., Martin, P. A., Kourt, G., Chilov, M., Sharma, V., & Benger, R. (2006). Management of periocular basal and squamous cell carcinoma: a series of 485 cases. American Journal of Ophthalmology, 142(2), 293-7.
Nemet AY, et al. Management of Periocular Basal and Squamous Cell Carcinoma: a Series of 485 Cases. Am J Ophthalmol. 2006;142(2):293-7. PubMed PMID: 16876511.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of periocular basal and squamous cell carcinoma: a series of 485 cases. AU - Nemet,Arie Y, AU - Deckel,Yael, AU - Martin,Peter A, AU - Kourt,Georgina, AU - Chilov,Michael, AU - Sharma,Vidushi, AU - Benger,Ross, PY - 2005/12/11/received PY - 2006/03/15/revised PY - 2006/03/24/accepted PY - 2006/8/1/pubmed PY - 2006/8/30/medline PY - 2006/8/1/entrez SP - 293 EP - 7 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 142 IS - 2 N2 - PURPOSE: To analyze the outcome of management of patients with basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) in a tertiary referral eye center in Sydney, Australia. DESIGN: Retrospective case series. METHODS: Review of medical records of 485 consecutive cases (469 patients) with confirmed eyelid cancer. Intervention procedures: Surgical excision with 3- to 5-mm clinically clear margins and histologic confirmation of the surgical margins. Frozen section histology or Mohs' micrographic surgery (MMS) was used for incompletely excised cases, and those located in the medial canthus or close to the lacrimal drainage system. Standard reconstruction techniques were employed. MAIN OUTCOME MEASURES: Survival period free of tumor, incomplete excision, recurrences, type of closure, and complications. RESULTS: Excision was initially incomplete in 25.4% of all tumors. Morpheaform type of BCC (chi(2)P < .001), and medial canthus location BCCs (chi(2)P < .05) were associated with a higher incomplete resection rate. A 35.9% incomplete excision rate was associated with a significantly higher recurrence rate compared with complete excision (8.4% and 4.6%, respectively, chi(2)P < .05). Twenty-seven patients (5.6%) had a recurrent tumor. After incomplete excision, there was no recurrence with MMS, but 4.7% recurrence rate when frozen section technique was used (P < .05). Local postoperative complications occurred in 41 patients (8.5%). CONCLUSIONS: In the setting of a tertiary referral center, incomplete primary resection of an eyelid skin cancer is the main risk factor for recurrence. Incomplete resection is significantly associated with medial canthus location and morpheaform type of BCC and with moderately differentiated SCC. MMS is the safer technique after incomplete tumor excision. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/16876511/Management_of_periocular_basal_and_squamous_cell_carcinoma:_a_series_of_485_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(06)00439-9 DB - PRIME DP - Unbound Medicine ER -