K 387
Predictors of recurrence of basal cell carcinoma of the eyelids and the periocular region
A. C. Zimmermann, V. Klauss
Introduction: The surgical excision of basal cell carcinoma of the eyelids often is in conflict with preserving lidfunction. Additionally the primary treatment gives by far the best chance of success. For this reason, factors predictive of basal cell carcinoma recurrence are important for pre- and postoperative planning.
Methods: Multiple regression analysis was performed to compare 153 basal cell carcinomas without recurrence of at least five years with 45 primary lesions of recurrent basal cell carcinomas. Location, ulceration, histological subtype and adequacy of surgical margins, photographically determined tumorsize, age and sex were analysed for their value to predict recurrence.
Results: Incompletely excised tumors were most likely to recurr. Moreover reexcised tumors had a higher recurrence rate than primary completely excised tumors. Morphea or sclerosing lesions had a significant higher tendency to recurr as nodular lesions did. The recurrency rate decreased with the tumors distance to the lidmargin.
Discussion: Factors predictive of basal cell carcinoma recurrence of the eyelids were identified. Predicting recurrence using these factors however is not possible in a clinical relevant dimension. With an estimated risk of recurrence of 50%, the calculated risk of a patient, based on these factors, was between 47% and 63%. So all patients with a basal cell carcinoma of the eyelids or periocular region must be reexamined regularly to detect recurrent lesions as early as possible, until more valuable factors are found. 89% of all recurrences occured within the first five postoperative years. Therefore this should be the minimal sufficient follow up time.
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