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Adjuvant therapy may reduce risk of ocular surface squamous neoplasia recurrence
Tarsal tumor location, positive surgical margins and other factors were associated with an increased risk of recurrence of ocular surface squamous neoplasia after surgical resection, according to a study.
“Furthermore, our data support using cryotherapy at the time of surgical removal and employing postoperative topical interferon in patients at greater risk for tumor recurrence,” the study authors said.
The retrospective study included 389 patients with a mean age of 61 years who underwent excisional biopsy of ocular surface squamous neoplasia lesions between January 2001 and September 2010. Two hundred seventy-four patients underwent concurrent cryotherapy to the surgical margins when the tumor was removed. One hundred ten patients underwent preoperative or postoperative adjuvant therapy with interferon, 5-fluorouracil or mitomycin C.
During follow-up, 44 excised lesions recurred. At 1 year, the recurrence rate was 10%, and at 5 years, the recurrence rate was 21%. The mean time to recurrence was 2.5 years. Mean follow-up was 23.4 ± 28 months.
Lesions that were classified as T2 and T3 had a significantly higher risk of recurrence than lesions classified as T1 (P = .07). Tarsal location increased the risk of recurrence (P = .007), but nasal location indicated a significantly lower risk of recurrence (P = .008). Presence of positive margins (P = .008) and higher grade lesions (P = .02) had a significant association with tumor recurrence.
Risk of tumor recurrence was significantly reduced by treatment with adjuvant cryotherapy (P = .03).
“In those patients with positive margins, the use of postoperative topical interferon therapy lowered the recurrence rate to a level similar to that of patients with negative margins,” the authors said.