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High rate of incomplete resection after primary excision of eyelid BCC: multi-staged resection rarely needs more than two procedures.
Orbit. 2011 Dec; 30(6):275-9.O

Abstract

PURPOSE

Small, well-demarcated, biopsy-proven periocular basal cell carcinomas (BCC) are often excised in a single stage with immediate reconstruction when histology or location is considered low-risk. We investigated margin clearance in patients undergoing primary excision and immediate reconstruction (PER) versus multi-staged fast paraffin excision (MSE) and reviewed risk factors for incomplete excision.

METHODS

Retrospective, interventional, comparative case series of periocular BCCs excised over a 3-year period (2006-2008).

RESULTS

Ninety consecutive patients with periocular BCC (average age 77 ± 10.1 years, 60% females) were included. 39% (35/90) underwent PER with the remainder managed by MSE (55/90, 61%). Patients undergoing MSE had larger lesions (38% > 10 mm versus 23% PER) which were more likely to involve the medial canthus (25 versus 11% PER). Incomplete histological clearance was noted in 34% (12/35) patients after PER. Only 3/55 (5%) needed third stage of excision in the MSE group with final incomplete excision in two cases (3.6%) that did not undergo a third stage excision. No significant risk factors were found likely to predict residual BCC overall, after first excision stage. Subgroup analysis for patients undergoing PER showed multiple lesions as the only statistically significant factor for incomplete excision.

CONCLUSION

This study shows an unacceptably high rate of incomplete resection with primary excision and repair using a standard 3 mm margin. The majority of lesions undergoing multi-stage excision required no more than two stages for complete removal. Multi-stage excision with histological confirmation of clear margins prior to reconstruction is recommended for routine management of all periocular BCC.

Authors+Show Affiliations

Birmingham and Midland Eye Centre, Birmingham, UK. anjukadyan@btinternet.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21955159

Citation

Kadyan, Anju, et al. "High Rate of Incomplete Resection After Primary Excision of Eyelid BCC: Multi-staged Resection Rarely Needs More Than Two Procedures." Orbit (Amsterdam, Netherlands), vol. 30, no. 6, 2011, pp. 275-9.
Kadyan A, Edmunds MR, Amissah-Arthur KN, et al. High rate of incomplete resection after primary excision of eyelid BCC: multi-staged resection rarely needs more than two procedures. Orbit. 2011;30(6):275-9.
Kadyan, A., Edmunds, M. R., Amissah-Arthur, K. N., & Durrani, O. M. (2011). High rate of incomplete resection after primary excision of eyelid BCC: multi-staged resection rarely needs more than two procedures. Orbit (Amsterdam, Netherlands), 30(6), 275-9. https://doi.org/10.3109/01676830.2011.603454
Kadyan A, et al. High Rate of Incomplete Resection After Primary Excision of Eyelid BCC: Multi-staged Resection Rarely Needs More Than Two Procedures. Orbit. 2011;30(6):275-9. PubMed PMID: 21955159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High rate of incomplete resection after primary excision of eyelid BCC: multi-staged resection rarely needs more than two procedures. AU - Kadyan,Anju, AU - Edmunds,Matthew R, AU - Amissah-Arthur,Kwesi N, AU - Durrani,Omar M, Y1 - 2011/09/28/ PY - 2011/9/30/entrez PY - 2011/10/1/pubmed PY - 2012/4/4/medline SP - 275 EP - 9 JF - Orbit (Amsterdam, Netherlands) JO - Orbit VL - 30 IS - 6 N2 - PURPOSE: Small, well-demarcated, biopsy-proven periocular basal cell carcinomas (BCC) are often excised in a single stage with immediate reconstruction when histology or location is considered low-risk. We investigated margin clearance in patients undergoing primary excision and immediate reconstruction (PER) versus multi-staged fast paraffin excision (MSE) and reviewed risk factors for incomplete excision. METHODS: Retrospective, interventional, comparative case series of periocular BCCs excised over a 3-year period (2006-2008). RESULTS: Ninety consecutive patients with periocular BCC (average age 77 ± 10.1 years, 60% females) were included. 39% (35/90) underwent PER with the remainder managed by MSE (55/90, 61%). Patients undergoing MSE had larger lesions (38% > 10 mm versus 23% PER) which were more likely to involve the medial canthus (25 versus 11% PER). Incomplete histological clearance was noted in 34% (12/35) patients after PER. Only 3/55 (5%) needed third stage of excision in the MSE group with final incomplete excision in two cases (3.6%) that did not undergo a third stage excision. No significant risk factors were found likely to predict residual BCC overall, after first excision stage. Subgroup analysis for patients undergoing PER showed multiple lesions as the only statistically significant factor for incomplete excision. CONCLUSION: This study shows an unacceptably high rate of incomplete resection with primary excision and repair using a standard 3 mm margin. The majority of lesions undergoing multi-stage excision required no more than two stages for complete removal. Multi-stage excision with histological confirmation of clear margins prior to reconstruction is recommended for routine management of all periocular BCC. SN - 1744-5108 UR - https://www.unboundmedicine.com/medline/citation/21955159/High_rate_of_incomplete_resection_after_primary_excision_of_eyelid_BCC:_multi_staged_resection_rarely_needs_more_than_two_procedures_ L2 - https://www.tandfonline.com/doi/full/10.3109/01676830.2011.603454 DB - PRIME DP - Unbound Medicine ER -