Mohs micrographic surgery for periocular skin cancer: a single-institution experience.

Periocular skin cancers require both effective and tissue-sparing treatment to minimize morbidity and preserve eyelid and lacrimal system function. We aim to define outcomes of periocular tumors treated with Mohs micrographic surgery (MMS) and factors associated with poor outcomes after surgery. This is a retrospective cohort study of all periocular tumors treated with MMS at an academic, large metropolitan-based referral center from January 1, 2013 to December 31, 2018. For 316 tumors from 307 patients, 75.3% of cases were basal cell carcinoma (BCC) (n = 238), 20.9% were squamous cell carcinoma (SCC) (n = 66), 2.5% were melanoma (n = 8), and 1.3% were primary adnexal carcinoma (n = 4). Over a mean follow-up of 47 months (range 12-108 months), local recurrence of two BCCs was observed. There were no recurrences for SCC, adnexal carcinoma, or melanoma. For BCC, previously treated tumors had higher risk for recurrence after MMS. AJCC 8 T stage was not associated with poor outcomes after MMS for periocular carcinoma or melanoma. Mohs micrographic surgery offers excellent cure rates for periocular cutaneous tumors. For basal cell carcinoma, previously treated lesions were associated with additional recurrence after MMS.

Shi K ，Wang L ，Srivastava D ，Nijhawan RI ... -  《-》

Recurrence of periocular basal cell carcinoma and squamous cell carcinoma after Mohs micrographic surgery: a retrospective cohort study.

Despite the widespread use of Mohs micrographic surgery (MMS) for periocular basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) - together called keratinocyte carcinoma (KC) - follow-up data regarding recurrences are limited. To investigate the recurrence rate for periocular KCs after MMS and to describe our experience with interdisciplinary collaborations. Patients with periocular KCs treated with MMS between 2006 and 2016 in a tertiary MMS referral hospital were included in this retrospective cohort study. Descriptive statistics were used to describe the MMS procedure-related characteristics. Using follow-up data from the electronic patient records and linkage with the Dutch nationwide network and registry of histopathology and cytopathology on 30 June 2017, the recurrence rate was evaluated and calculated using a cumulative incidence curve. In total, 683 (93·7%) periocular BCCs and 46 (6·3%) SCCs were treated with MMS. Three-quarters (n = 549) were primary tumours and the majority were located at the medial canthus or lower eyelid (n = 649, 89·0%). In 505 MMS procedures (69·3%) an oculoplastic surgeon participated, and in 63 patients (8·6%) a plastic surgeon performed the reconstruction. After a median follow-up of 46 months the recurrence rate was 3·0%, based on 22 recurrences (20 BCCs and two SCCs). MMS is an excellent treatment option for periocular KCs, with a low recurrence rate. Due to this specific anatomical location an interdisciplinary approach should pre-eminently be considered.

Weesie F ，Naus NC ，Vasilic D ，Hollestein LM ，van den Bos RR ，Wakkee M ... -  《-》

Recurrence rates of periocular basal cell carcinoma following Mohs micrographic surgery: a retrospective study.

The incidence of basal cell carcinoma (BCC) has increased during the previous decade. Mohs micrographic surgery (MMS) is the gold standard technique for BCCs. The aim of this study was to investigate the recurrence rate of periocular BCCs following MMS in a regional Mohs treatment facility in the United Kingdom. The study comprised a retrospective case note review of 480 patients who underwent MMS from 2001 to 2006 for periocular BCC. Patients were identified via hospital coding databases. Medical records were reviewed, and the parameters collected include age, gender, previous BCCs and treatment modality, postoperative complications and subsequent management, site, size of lesion, histological subtype, and recurrence following MMS. Three hundred and ninety of the 480 patients identified were included. The remaining patients had died before the 5-year analysis (65), were lost to follow-up (20), or were identified as having Gorlin's syndrome (5). The majority of BCCs were 6-10 mm (42%) and nodular (45%). Six recurrences were identified (1.5%), including one (0.3%) primary BCC and five (6.5%) recurrent BCCs at the time of the MMS. The mean follow-up was 30 months (range 1-120 months). For BCC in the periocular region, MMS should be the treatment of choice for both primary and recurrent periocular BCCs. The increased recurrence rate, demonstrated by recurrent BCCs, highlights the need for a comprehensive follow-up.

Sin CW ，Barua A ，Cook A 《-》

Characteristics of non-melanoma skin cancers of the cutaneous perioral and vermilion lip treated by Mohs micrographic surgery.

The lip and surrounding perioral region are susceptible to non-melanoma skin cancer, but the distribution of basal cell and squamous cell carcinoma on the cutaneous and vermilion lips has not been fully elucidated. To investigate the distribution of cutaneous and vermilion lip non-melanoma skin cancer and to better describe risk factors, anatomic location, treatment characteristics and oncologic outcomes. A retrospective comparative case series of patients undergoing Mohs micrographic surgery (MMS) at a single academic centre for lip and perioral basal cell and squamous cell carcinoma was performed over a 5-year period. Demographics, medical comorbidities, surgical characteristics and recurrence status were extracted. Forty-five vermilion and 116 cutaneous lip cancers were identified. Basal cell carcinoma (BCC) was more common in the cutaneous perioral region, while squamous cell carcinoma (SCC) was more common on the vermilion lip (P < 0.001). BCCs were more common on the upper vermilion lip and SCCs were more common on the lower vermilion lip (P < 0.001). Within the cutaneous perioral region, both BCCs and SCCs were more common on the upper perioral surface (P = 0.002). Male gender was associated with lower lip SCC (P = 0.015). Smoking, immunosuppression, anticoagulant use and hydrochlorothiazide use were not associated with cancer type or location. Recurrences were rare, but more common in vermilion lip cancers (6.6%) compared to perioral cutaneous cancers (0.8%). Outcomes for all groups were similar; BCCs of the vermilion lip had significantly greater mean MMS stages (P < 0.001) as did SCCs (P = 0.05). Basal cell carcinoma is more commonly encountered on the cutaneous lip, whereas SCC is more common on the vermilion lip. Within the vermilion lip, BCC favours the upper lip, while SCC favours the lower lip. Within the cutaneous perioral region, both BCC and SCC favour the upper cutaneous tissue. Early stage lip cancers are curable by Mohs micrographic surgery with rare recurrences.

Queen D ，Knackstedt T ，Polacco MA ，Collins LK ，Lee K ，Samie FH ... -  《-》

Outcomes of Mohs micrographic surgery for periocular squamous cell carcinoma.

Hartley MJ ，Meredith PR ，Oliphant T 《-》