Risk factors associated with relapse of eyelid basal cell carcinoma: results from a retrospective study of 142 patients

Fatigato, Giusy; Capitani, Silvano; Milani, Daniela; Grassilli, Silvia; Alameen, Ayman Ali Mohammed; Candiani, Marco; Riberti, C; Galasso, Marco; Previati, Maurizio

doi:10.1684/ejd.2017.3026

Cited by 6 publications

(4 citation statements)

References 20 publications

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“…Our study provides novel demographic information and histological features of eyelid tumors in this region and documented differences in the behavior of BCC confirming some aspects of this lesion reported in other regions as a preponderance in aging (69.4 ± 16 years old) 1 18 19 20 and rare occurrence in the youngest to 40 years.…”

Section: Discussionsupporting

confidence: 86%

Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain

Galindo‐Ferreiro

Sánchez-Tocino

Diez-Montero

et al. 2020

Journal of Current Ophthalmology

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Purpose: To define the incidence, characteristics, and management of eyelid basal cell carcinoma (BCC) in Central Spain. Methods: This retrospective study investigates the characteristics and the outcome of eyelid BCC from 2000 to 2016 in a central region of Spain. Data were collected on demographics, skin phenotype, location of the eyelid lesion, clinical and histological diagnosis, surgery, commitment of surgical margins, and recurrence rate. Results: Primary eyelid BCC occurred in a mean of 20.6 lesions a year or 9.4/100,000 inhabitants/year. The mean age of BCC carriers was 69.4 ± 16.2 years, with no gender difference (P = 0.479), predominantly affecting Fitzpatrick II–III skin (81.3%) (P < 0.001). The most common location was the inner canthus (154/45.7%) (P < 0.001) and type nodular (215 cases/63.8%) (P < 0.001). The surgical margins were affected in 69 (20.5%) individuals, and the recurrence rate was 5.6 (95% confidence interval, 3.2–8.3) significantly higher in affected margins (P < 0.001). The most common location for recurrence was the inner canthus (P = 0.003), and the most common histological type for recurrence was sclerosing (16.7%), then multinodular (12.5%), and infiltrating (10.4%) with no significant difference (P = 0.27). Conclusions: The frequency of occurrence of eyelid BCC is much less than the estimated crude incidence for skin tumors involving all areas of the body in the Spanish population. Eyelid BCC is more common in the seventh decade of life, with no predilection for gender. Nodular histological type is the most common. The recurrence rate is 5.6%, depending on site and affected margins, even though clear free margins also can present with recurrence.

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Section: Discussionsupporting

confidence: 86%

Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain

Galindo‐Ferreiro

Sánchez-Tocino

Diez-Montero

et al. 2020

Journal of Current Ophthalmology

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“…Specific anatomical factors also likely play a large role in the risk of incomplete excision. Periocular lesions appeared to be at greater risk, as shown by the relatively high risk with ophthalmology and plastic surgery studies on this subset of patients 67,87 . Additionally, high‐risk histological lesions, such as morphoeic BCCs, have been shown to be at higher risk of incomplete excision.…”

Section: Discussionmentioning

confidence: 87%

“…Periocular lesions appeared to be at greater risk, as shown by the relatively high risk with ophthalmology and plastic surgery studies on this subset of patients. 67,87 Additionally, high-risk histological lesions, such as morphoeic BCCs, have been shown to be at higher risk of incomplete excision. In this systematic review, due to a lack of reporting of some high-risk elements such as perineural invasion, it was not possible to extract data on histological factors.…”

Section: Discussionmentioning

confidence: 99%

Incomplete surgical excision of keratinocyte skin cancers: a systematic review and meta‐analysis*

et al. 2020

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Summary Background Keratinocyte or nonmelanoma skin cancer (NMSC) is the commonest malignancy worldwide. The usual treatment is surgical excision. Current guidelines underestimate incomplete excision rates. Objectives We aimed to determine the risk of incomplete excision of NMSCs through a systematic review and meta‐analysis of primary clinical studies. Methods A PRISMA‐compliant systematic review and meta‐analysis was performed using methodology proposed by Cochrane (PROSPERO CRD42019157936). A comprehensive search strategy was applied to MEDLINE, Embase, Scopus, CINAHL, EMCare, Cochrane Library and the grey literature (January 2000–27 November 2019). All studies were included except those on Mohs micrographic surgery, frozen section or biopsies. Abstract screening and data extraction were performed in duplicate. Risk of bias was assessed using a tool for prevalence/incidence studies. The primary outcome was the proportion of incomplete surgical excisions. A random‐effects model for pooling of binomial data was used. Differences between proportions were assessed by subgroup meta‐analysis and meta‐regression, which were presented as risk ratios (RRs). Results Searching identified 3477 records, with 110 studies included, comprising 53 796 patients with 106 832 basal cell carcinomas (BCCs) and 21 569 squamous cell carcinomas (SCCs). The proportion of incomplete excisions for BCC was 11·0% [95% confidence interval (CI) 9·7–12·4] and for SCC 9·4% (95% CI 7·6–11·4). Proportions of incomplete excisions by specialty were: dermatology, BCCs 6·2% and SCCs 4·7%; plastic surgery, BCCs 9·4% and SCCs 8·2%; general practitioners, BCCs 20·4% and SCCs 18·9%. The risk of incomplete excision for general practitioners was four times that of dermatologists for both BCCs (RR 3·9, 95% CI 2·0–7·3) and SCCs (RR 4·8, 95% CI 1·0–22·8). Studies were heterogeneous (I2 = 98%) and at high risk of bias. Conclusions The proportion of incomplete excisions is higher than previously reported. Excisions performed by specialists may lower the risk of incomplete excision.

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“…The periocular skin-eyelid area has a distinguished role in the protection of the ocular surface and thus in the maintenance of clear vision. Unfavorable outcome of the treatment can result in loss of vision and distorting scars can deeply impact the patient’s quality of life 22,23 .…”

Section: Discussionmentioning

confidence: 99%

Electrochemotherapy in the treatment of locally advanced or recurrent eyelid-periocular basal cell carcinomas

Kis

Baltás

Ócsai

et al. 2019

Sci Rep

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There is increasing evidence about the effectiveness of electrochemotherapy (ECT) in the treatment of basal cell carcinomas in the head and neck region, although its role in the management of eyelid-periocular skin tumors has to be clarified. The aim of the present study is to evaluate the results of ECT in the treatment of locally advanced primary and recurrent eyelid-periocular skin basal cell carcinomas. Twelve patients with basal cell carcinoma involving the eyelid-periocular skin region were treated with ECT. Three patients had locally advanced primary tumors, while 9 patients had recurrent tumors. All treatments were performed according to the ESOPE guidelines, using Cliniporator TM device. All patients received bleomycin based ECT. The route of administration was intratumoral in 3 patients and intravenous in 9 patients. Tumor response was evaluated using the RECIST 1.1. criteria. ECT resulted in complete response of the periocular skin tumors in all patients. Lower eyelid ectropion was developed in 3 patients which had to be corrected surgically. ECT can be used effectively in the treatment of locally advanced or recurrent basal cell carcinomas in the eyelid-periocular skin region. Excellent tumor control can be achieved with good functional and cosmetic results without systemic adverse events with short interval follow-up.

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Risk factors associated with relapse of eyelid basal cell carcinoma: results from a retrospective study of 142 patients

Cited by 6 publications

References 20 publications

Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain

Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain

Incomplete surgical excision of keratinocyte skin cancers: a systematic review and meta‐analysis*

Electrochemotherapy in the treatment of locally advanced or recurrent eyelid-periocular basal cell carcinomas

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