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Minimum histologic safety margin may stall recurrence of basal cell carcinoma of lid
Ophthalmology. 2009;116(4):802-806.
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Periorbital basal cell carcinoma of the eyelid is unlikely to recur in the presence of small histologic safety margins, a study found.
"At critical and visually easily accessible tumor sites (eg, adjacent to the lacrima puncta) a re-section in solid [basal cell carcinomas] with tumor-positive margins may not be mandatory, provided the surgical site is clinically inspected regularly," the study authors said.
The cohort study included 101 patients who underwent surgical treatment for basal cell carcinoma between 1997 and 1999. The mean follow-up interval was 7 years (range, 104 days to 9.7 years).
Investigators retrospectively used digital imaging to measure tumors' minimum histologic safety margin. They calculated histologic safety margin according to tumor-free section numbers in some cases.
At mean follow-up of 34.7 months, seven patients (6.93%) had recurring tumors. Patients were divided into three groups: 11 patients without histologic safety margin and three tumor recurrences; 18 patients with histologic safety margin less than 0.2 mm and three recurrences; and 72 patients with histologic safety margin greater than 0.2 mm and one recurrence.
Differences in recurrence rates between groups with and without histologic safety margins and between the groups with histologic safety margins were statistically significant (P = .01 and P = .03, respectively), the authors reported.
"This conclusion does not apply to fibrous BCC," they said.