title: The Australian Mohs database, part II: periocular basal cell carcinoma outcome at 5-year follow-up.
abstract: OBJECTIVE
  To report the outcome with 5-year strict follow-up (only cases where 5-year follow-up is available) of all patients with periocular basal cell carcinoma (BCC) treated with Mohs' micrographic surgery (MMS) in Australia between 1993 and 1996.
  
  
  METHODS
  Prospective, noncomparative, multicenter, interventional case series.
  
  
  METHODS
  A prospective series of 819 patients, undergoing MMS for periocular BCC over a 3-year period (1993-1996).
  
  
  METHODS
  Periocular BCC referred for MMS.
  
  
  METHODS
  Recurrence, site, size, prior occurrence, defect size, histologic subtype, and presence of perineural invasion.
  
  
  RESULTS
  Eight hundred nineteen patients had 257 (54%) lower eyelid, 195 (41%) medial canthus, and 22 (5%) upper eyelid BCCs. The most common histologic subtypes were nodulocystic (43%) and infiltrating (30%) (P = 0.0003). Sixty-eight percent were primary and 32% were recurrent tumors. Five-year follow-ups for cases between 1993 and 1996 were available in 347 (42%) cases. There were 7 recurrences (2.0%; exact 95% confidence interval [CI]: 0.82%-4.1%), 5 of which were at the medial canthus and all of which were previously recurrent, with up to 3 recurrences before MMS. Previous recurrence (P<0.0001), infiltrating (5) or superficial (2) histologic subtype (P = 0.0882), and medial canthal site were the main predictors of recurrence after MMS. There were no recurrences for primary BCC, and the 5-year recurrence for previously recurrent BCC was 7.8% (exact 95% CI: 3.2%-15.4%).
  
  
  CONCLUSIONS
  The Australian MMS database is the largest prospective nationwide series of periocular BCC managed by MMS. The strict 5-year recurrence rates of 0% and 7.8% for primary and recurrent tumors, respectively, confirm MMS as the treatment of choice for periocular BCC.
authors.affiliation: Oculoplastic and Orbital Unit, Department of Ophthalmology, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
authors.forename: Raman
authors.initials: R
authors.lastname: Malhotra
authors.forename: Shyamala C
authors.initials: SC
authors.lastname: Huilgol
authors.forename: Nghi T
authors.initials: NT
authors.lastname: Huynh
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D016208:Databases, Factual; D005142:Eyelid Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016896:Treatment Outcome