title: Risk factors for orbital exenteration in periocular Basal cell carcinoma.
abstract: OBJECTIVE
  To present the proportion of patients with periocular basal cell carcinoma (BCC) who underwent orbital exenteration and to evaluate the significance of the following risk factors: initial tumor site, pathologic features, and initial treatment.
  
  
  METHODS
  Retrospective, comparative, interventional case series.
  
  
  METHODS
  Charts of all patients with BCC referred to Orbital Unit of the University of Naples "Federico II" between 1984 and 2003 were reviewed. Charts were reviewed for patient demographics, previous treatments, tumor site, clinical presentation, duration of symptoms, and histologic subtype. The main outcomes were recurrence rate, tumor-related deaths, orbital infiltration, and rate of exenteration.
  
  
  RESULTS
  Data (including follow-up) were available for 506 patients. Twenty-eight patients (5.5%) underwent orbital exenteration. For 8 patients (28.5%), orbital exenteration was the first procedure performed. In the exenterated group, the most common tumor site was the medial cantus, whereas in the overall group, it was the lower eyelid (P = .001). The proportion of patients initially treated without margin control was significantly higher in patients undergoing exenteration (P = .0001). Pathologic examination revealed a higher incidence of infiltrative subtype in the exenterated group (P = .00019).
  
  
  CONCLUSIONS
  The need for exenteration for BCC may be significantly higher when the lesion involves a medial canthal location, initial management does not include margin-controlled excision, or pathologic analysis reveals an infiltrative subtype. Margin-controlled excision for periocular BCC and close follow-up after excision for medial canthal BCC may be indicated.
authors: Department of Ophthalmological Sciences, University of Naples Federico II, Naples, Italy.
authors: Adriana
authors: A
authors: Iuliano
authors: Diego
authors: D
authors: Strianese
authors: Giovanni
authors: G
authors: Uccello
authors: Agostino
authors: A
authors: Diplomatico
authors: Sabrina
authors: S
authors: Tebaldi
authors: Giulio
authors: G
authors: Bonavolontà
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005142:Eyelid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D017233:Orbit Evisceration; D009918:Orbital Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate