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Mohs’ excision technique associated with lower eyelid tumor recurrence rate
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Treating incompletely excised eyelid tumors using Mohs’ micrographic surgery may result in a lower recurrence rate compared with frozen section histology, according to a study.
Arie Y. Nemet, MD, and colleagues at the Sydney Hospital and the Sydney Eye Hospital, Australia, retrospectively reviewed their results treating patients with basal cell carcinomas and squamous cell carcinomas. The study included records for 485 consecutive cases of 469 patients.
Surgeons initially excised tumors to within 3- to 5-mm of the clinically clear margins and confirmed the surgical margins histologically. They then used either frozen section histology or Mohs’ micrographic surgery to treat incompletely excised cases as well as cases located in the medial canthus or close to the lacrimal drainage system, according to the study.
During follow-up, 27 patients (5.6%) experienced a tumor recurrence.
The researchers found that the main risk factor for recurrence was incomplete primary tumor excision, which occurred in 25.4% of cases. An incomplete excision rate of 35.9% was associated with a 8.4% recurrence rate, significantly higher than the 4.6% recurrence rate with complete excision (X²P < .05).
Incomplete resections were significantly associated with tumor type and location, particularly the morpheaform type of BCC (X²P < .001) and basal cell carcinomas located on the medial canthus (X²P < .05). However, no cases treated with Mohs’ micrographic surgery after incomplete excision experienced a recurrence, while 4.7% of cases treated with frozen section had a recurrence (P < .05), according to the study.
The study was published in the American Journal of Ophthalmology.