Factors in the Successful Surgical Management of Basal Cell Carcinoma of the Eyelids

Doxanas, Marcos T.; Green, W. Richard; Iliff, Charles E.

doi:10.1016/0002-9394(81)90005-2

Cited by 100 publications

(47 citation statements)

References 11 publications

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“…These findings are in agreement with other studies which show recurrence rates of 25-35% for incompletely removed tumours (Taylor & Barisoni 1973;Koplin & Zarem 1980;Doxanas et al 1981;Gooding et al 1965). We believe that by using the simple classification presented in this paper communication between the pathologist and the surgeon may be improved and the pathologists' report may be used as a guideline for further treatment.…”

Section: Discussionsupporting

confidence: 92%

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Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Sigurðsson

Agnarsson

1998

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To examine all basal cell carcinomas of the eyelid diagnosed in Iceland during a 25-year period, paying special attention to the surgical margins of excision in relation to recurrence. Based on the results a simple, clinically relevant method of classifying the surgical margin is proposed. Methods: All histologically proven basal cell cancer specimens from eyelids were reviewed retrospectively. The surgical excision margins were classified as radical, marginal or intralesional. Results: Recurrence risk was low when the tumor had a surgical margin described as radical or marginal. The recurrence rate was 38% when the margin was intralesional. Conclusion: By assessing the surgical margins by this method, which is easy to apply, better understanding between the pathologist and the surgeon may be achieved.

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Section: Discussionsupporting

confidence: 92%

“…These are usually the most benign forms of BCC tumors (Doxanas et al 1981). The surgery was performed by various physicians, including general practitioners, reflecting that most of these tumors were small.…”

Section: Discussionmentioning

confidence: 99%

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Sigurðsson

Agnarsson

1998

Acta Ophthalmologica Scandinavica

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“…26 We opt for ensuring complete excision for all our BCC as reports show recurrence rates varying between 30 and 50% for incompletely excised BCC depending on the length of follow-up. 27 Recurrence can be difficult to diagnose in the periocular area as the recurrent tumour may arise in the deeper margins and can spread subdermally or into the orbit.…”

Section: Discussionmentioning

confidence: 99%

5 Years review of periocular basal cell carcinoma and proposed follow-up protocol

Brown

Bamford

et al. 2012

Eye

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In all, 67% were nodular BCC and 45.4% located in the lower eyelid. The main outcome measure was the recurrence rate. None of the patients with primary nodular BCC suffered recurrence. The recurrence rate for primary morphoeaform BCC following complete excision is 3.8%. In total, 8.1% of patients had several lesions simultaneously whereas 7.8% patients had BCC in multiple locations subsequently (metachronous). Three patients who had previously recurrent BCC (rBCC) treated elsewhere or not using this method had orbital/lacrimal drainage system involvement requiring exenteration. Conclusion We recommend that patients with a single, completely excised primary solid or nodular BCC can be discharged after one 6-monthly review, although they should be instructed to monitor for the development of further lesions. The incidence of recurrence for primary morphoeaform BCC is 3.8% and for rBCC is 3.6% over 5 years and these patients should stay under review for this period.

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“…16 Micrographic surgery and frozen section control in all of 165 eyelid basal cell carcinomas 17 resulted in a recurrence rate of 2.19% (137 were followed at least 3 months, mean 29.1 months). Nearly all other authors restricted the use of micrographic surgery and intraoperative frozen section control to larger or recurrent tumours and to morphoea type lesions to reduce the time and efforts, [18][19][20] as Frank 17 recommended in the conclusion of his study. This, however, raised the recurrence rate to 4-5%.…”

Section: Discussionmentioning

confidence: 99%

A reappraisal of cryosurgery for eyelid basal cell carcinomas

Buschmann

2002

British Journal of Ophthalmology

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Background/aims: Liquid nitrogen spray freezing has been successfully applied for basal cell carcinomas in the eyelid region, but is not yet in general use. The reasons for this were analysed and the development of a more reliable, safer cryosurgical technique aimed for. Methods: New cryosurgical apparatus, contact probes with increased freezing power, and a special application technique were developed and clinically tested in a consecutive series of 221 patients with primary basal cell carcinomas of the lid region. Special efforts yielded follow up reports of 220 out of the 221 patients. Results: Experimental measurements and clinical results demonstrated that this cryosurgical technique was at least as effective as spray freezing, with lower risks. The rate of recurrent tumours in patients followed up for 5 years or longer was 5.1% (surgeons first result) respectively 0.6% (result after optimised second cryosurgery). The figures were 6.8%, respectively max 2.7%, when including all patients, independent of follow up time. Conclusion: Traditional surgery and histopathology, still used at numerous places, resulted in higher recurrence rates despite extended loss of healthy eyelid tissues and should be abandoned. Micrographic surgery is considered mandatory to save more of the healthy structures and to obtain lower recurrence rates. Cost and time require worldwide restriction of micrographic surgery to selected cases. Updated cryosurgery provides a low cost option to micrographic surgery and results in preservation of eyelid structures and lacrimal pathways, tarsal plate, lid margin. It provides excellent cosmetic results. Thus, primary basal cell carcinomas in the eyelid region of suitable size and location should receive updated cryosurgery, and tumours beyond its range micrographic surgery.

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Factors in the Successful Surgical Management of Basal Cell Carcinoma of the Eyelids

Cited by 100 publications

References 11 publications

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins

5 Years review of periocular basal cell carcinoma and proposed follow-up protocol

A reappraisal of cryosurgery for eyelid basal cell carcinomas

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