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Mohs micrographic surgery for periocular skin cancer: a single-institution experience
Kevin Shi1, Laura Wang1, Divya Srivastava1
1Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, 4th Floor Suite 100, Dallas, TX, USA.
Abstract:
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.
Insights
Mohs micrographic surgery (MMS) provides high cure rates for periocular skin cancers. Previously treated basal cell carcinomas showed a higher recurrence risk after MMS.
Area of Science:
- Dermatology
- Ophthalmology
- Oncology
Background:
- Periocular skin cancers necessitate treatments balancing efficacy with tissue preservation.
- Maintaining eyelid and lacrimal system function is crucial post-treatment.
Purpose of the Study:
- To evaluate the outcomes of periocular tumors treated with Mohs micrographic surgery (MMS).
- To identify factors associated with adverse outcomes following MMS for these tumors.
Main Methods:
- Retrospective cohort study of periocular tumors treated with MMS.
- Data collected from an academic, metropolitan referral center (2013-2018).
- Analysis of tumor types, recurrence rates, and prognostic factors.
Main Results:
- 316 tumors from 307 patients analyzed: 75.3% basal cell carcinoma (BCC), 20.9% squamous cell carcinoma (SCC), 2.5% melanoma, 1.3% adnexal carcinoma.
- Excellent cure rates observed with only two BCC recurrences over a mean follow-up of 47 months.
- Previously treated BCCs demonstrated a higher risk of recurrence post-MMS.
Conclusions:
- Mohs micrographic surgery achieves excellent cure rates for periocular cutaneous malignancies.
- Previously treated basal cell carcinomas represent a higher risk group for recurrence after MMS.
