Outcomes following wide local excision of periocular basal cell carcinoma: A 10-year review
Author: Aleena Thomas
Base Hospital / Institution: Ninewells Hospital, Dundee, Scotland
ePoster presentation
Abstract ID: 25-220
Purpose
To conduct a 10-year retrospective analysis of patients undergoing wide local excision (WLE) for periocular Basal Cell Carcinomas (BCC) at a teaching hospital with the aim of determining local recurrence rate.
Methods
Using electronic patient operating logs, patients who had WLE of periocular BCC were identified (coded as ‘excision of lesion’) between the years 2014-2024. Data was collected under the parameters: date of excision, histology of lesion, excision margin and date of recurrence (if applicable). Patient demographic information (gender, age) was also collected. Information on recurrence was obtained using clinical letters and the electronic histology portal. Patients with other malignancies and benign lesions were excluded. Margins were defined in three categories – “clear margins” if 1mm or more, “close margin” if less than 1mm and “not clear” if margin was involved. All data was coded into an Excel spreadsheet for analysis.
Results
The initial search yielded 600 patients. Of these, 228 patients had a histologically confirmed diagnosis of BCC. 99.6% of patients had a primary BCC with mixed nodular and infiltrative histology. The recurrence rate was found to be 4.2%. 54.5% of patients with recurrence had close histopathological margin clearance, 36.4% had clear margins and 9% involved margins. Average follow-up was 15 months post-procedure (range=2-77 months) and the average time for recurrence was 42 months.
Conclusion
Mohs Micrographic Surgery (MMS) is the gold standard for BCC excision as it allows for narrow surgical margins and a higher success rate. However, limitations include cost and waiting times. Therefore, WLE is a widely used alternative. From the literature, recurrence rate following WLE of BCC is quoted to be 1.2-23%. Our 10-year single centre study demonstrated equivocal results with WLE, 4.2%. To conclude, WLE may be a suitable alternative for a large proportion of patients and MMS should be reserved for high-risk BCCs. Future directions of study may include a randomised control trial comparing recurrence rates between WLE and MMS for periocular BCCs.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Bayan | Shahin | Ninewells Hospital, Dundee, Scotland |
| Dalia | Zeinalabedien | Ninewells Hospital, Dundee, Scotland |
