The Australian Mohs database, part I: periocular basal cell carcinoma experience over 7 years.
OBJECTIVE
To present the findings of all patients with periocular basal cell carcinoma (BCC) treated with Mohs' micrographic surgery (MMS) in Australia between 1993 and 1999.


METHODS
Prospective, noncomparative, multicenter, interventional case series.


METHODS
Prospective series of 1295 patients undergoing MMS for periocular BCC over a 7-year period (1993-1999).


METHODS
Periocular BCC referred for MMS.


METHODS
Site, tumor size, prior occurrence, defect size, histologic subtype, and presence of perineural invasion.


RESULTS
Twelve hundred ninety-five patients had 615 (47.5%) lower eyelid, 626 (48.3%) medial canthus, and 51 (3.9%) upper eyelid BCCs. The most common histologic subtypes were nodulocystic (39.5%) and infiltrating (34.8%) (P = 0.0008). Sixty-eight percent were primary and 32% were recurrent tumors. Previously recurrent BCCs were larger (P<0.0001), with larger defects (P<0.0001) than primary BCCs, and had more subclinical extension (P<0.0001) requiring more levels for complete excision (P<0.0001). Furthermore, superficial BCCs were more likely to have a prior occurrence (P<0.0001). In this series, perineural invasion was found in 1% of cases, with greater subclinical tumor extension in such cases (P = 0.0657).


CONCLUSIONS
The Australian MMS database is the largest prospective, nationwide series of high-risk periocular BCC managed by MMS. Almost 50% of tumors were at the medial canthus, with nodulocystic and infiltrating being the most common histologic subtypes. Recurrent BCCs comprised a third of tumors and were larger, with larger defects and more subclinical extension than primary BCCs. Perineural invasion was found in 1% of cases and also had greater subclinical extension.
Malhotra
Raman
R
Oculoplastic and Orbital Unit, Department of Ophthalmology, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
Huilgol
Shyamala C
SC
Huynh
Nghi T
NT
Selva
Dinesh
D
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; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011446:Prospective Studies