Long-term outcomes after adjunctive topical 5-flurouracil or mitomycin C for the treatment of surgically excised, localized ocular surface squamous neoplasia.
BACKGROUND
To report rates of recurrence and complications of localized ocular surface squamous neoplasia treated with 5-fluorouracil or mitomycin C as adjunctive treatment to surgical excision.


METHODS
Long-term follow up of two prospective, non-comparative interventional case series.


METHODS
One hundred fifty-three eyes with histologically confirmed localized, non-invasive ocular surface squamous neoplasia. 89 eyes were treated with adjuvant 5-fluorouracil and 64 eyes were treated with adjuvant mitomycin C.


METHODS
Following surgical excision±cryotherapy patients received topical 5-fluorouracil 1% four times daily for two weeks or topical mitomycin C 0.04% four times daily for two to three 1-week cycles.


METHODS
Ocular surface squamous neoplasia recurrence, complications of therapy and compliance.


RESULTS
Median follow up was 33.6 (range 12-84) months and 57.9 (range 12-160) months in 5-fluorouracil and mitomycin C groups, respectively. There was one recurrence in the 5-fluorouracil group and no recurrences in the mitomycin C group. Side-effects occurred in 69% of 5-fluorouracil patients and 41% of mitomycin C patients. Five patients (6%) required intervention for treatment-related side-effects in the 5-fluorouracil group versus 11 (17%) in the mitomycin C group. No vision-threatening complications were noted.


CONCLUSIONS
Long-term recurrence of localised ocular surface squamous neoplasia is rare when topical 5-fluorouracil or mitomycin C are used as adjunctive treatment to surgical excision. While side-effects are common, the majority are transient and rarely limit compliance.
South Australian Institute of Ophthalmology, Adelaide, Australia; Discipline of Ophthalmology and Visual Sciences, University of Adelaide, North Terrace, South Australia, Australia.
Bobak
B
Bahrami
Timothy
T
Greenwell
James S
JS
Muecke
D000287:Administration, Topical; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003230:Conjunctival Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003316:Corneal Diseases / Q000188:drug therapy* / Q000601:surgery; D017679:Cryotherapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D016896:Treatment Outcome
D000477:Alkylating Agents; D009883:Ophthalmic Solutions; D016685:Mitomycin; D005472:Fluorouracil
OSSN; chemotherapy; ocular oncology; ocular surface tumours