Abstract Listings 2024

Purpose

Staged excision of periocular BCCs is increasingly being performed by training-grade surgeons as part of their training. We evaluate the clearance of BCC staged excisions performed by surgeons of various grades in our hospital.

Methods

A retrospective case series of all periocular BCCs managed with staged excisions from January 2023 to December 2023 in a tertiary ocular oncology centre in the United Kingdom.

Results

Staged excision of 102 cases of periocular BCCs was identified from the histopathological database. 46% (n=47) of BCCs were completely excised following the first stage, while 32% (n=33) had close margins (<1 mm) and 22% (n=22) had contaminated margins. BCCs were completely excised by consultants following the first stage in 53% (16/30) of cases, compared to 47% (15/32) by fellows, 40% (12/30) by senior residents (years 4-7), and 40% (4/10) by junior residents (years 1-3) (p=0.74). 42% (n=43) of patients, including all of those with contaminated margins, underwent further excisions to achieve clearance, resulting in an 88% complete excision rate following staged excisions. Twelve patients with close margins did not undergo further excision; six patients refused further surgery, and the rest had well-defined, low-risk types of BCCs.

Conclusion

There was no statistically significant difference in the rate of complete excision of periocular BCCs after the first stage of staged excisions between surgeons of varying grades. Cases were selectively allocated depending on the degree of complexity and the level of the surgeon’s experience and surgical capabilities. Supported further training and targeted case selection have an impact on improving clearance rates.

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