Recurrence of periocular basal and squamous cell carcinoma after Mohs Micrographic Surgery: a retrospective cohort study

Abstract

Background

Despite the widespread use of Mohs Micrographic Surgery (MMS) for periocular basal and squamous cell carcinoma (together called keratinocyte carcinoma (KC)), follow‐up data regarding recurrences are limited.

Objectives

To investigate the recurrence rate for periocular KCs after MMS and describe experience with interdisciplinary collaborations.

Methods

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. By follow‐up data from the electronic patient records and linkage with the Dutch nationwide network and registry of histopathology and cytopathology (PALGA) June 30^th 2017, the recurrence rate was evaluated and calculated by using a cumulative incidence curve.

Results

In total, 683 (93·7%) periocular basal cell carcinomas (BCCs) and 46 (6·3%) squamous cell carcinomas (SCCs) were treated with MMS. Three‐quarters (n=549) were primary tumours and the majority was located at the medial canthus or lower eyelid (n=649, 89·0%). In 505 MMS procedures (69%) 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 is 3·0%, based on 22 recurrences (20 BCCs and 2 SCCs).

Conclusions

MMS is an excellent treatment option for periocular KCs with a low recurrence rate. Due to its specific location an interdisciplinary approach should pre‐eminently be considered.

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