Outcomes of Excision of 1750 Eyelid and Periocular Skin Basal Cell and Squamous Cell Carcinomas by Modified En Face Frozen Section Margin-controlled Technique

Gayre, Gregg S.; Hybarger, C. Patrick; Mannor, Geva; Meecham, William J.; Delfanti, John B.; Mizono, Gary S.; Guerry, Thomas L.; Chien, Jeffrey S.; Sooy, C. Daniel; Anooshian, Robert; Simonds, Roderick; Pietila, Karen A.; Smith, David W.; Dayhoff, Deborah A.; Engman, Elaine; Lacy, John

doi:10.1097/iio.0b013e3181b802ee

Cited by 23 publications

(19 citation statements)

References 39 publications

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“…Ainsi seule l'analyse des bords latéraux est recherchée. L'extemporané des bords ou margins frozen section, edges frozen section, square technique, spaghetti technique, in face technique, perimeter technique, en-face frozen margin-controlled technique est une technique pour laquelle les taux de récidive par analyse actuarielle à 5 ans sont de l'ordre de 0 à 4,5 % pour les CBC primaires [4,11,12]. Il s'agit d'une chirurgie qui associe l'exérèse de la tumeur à un contrôle histologique des berges péri-tumorales : une exérèse in toto de la lésion tumorale en respectant des marges de sécurité de 1 à 2 mm est effectuée ; le chirurgien réalise ensuite des recoupes complémentaires de 1 à 2 mm de large sur lesquelles sera effectué l'examen extemporané (Fig.…”

Section: Marges D'exérèse Des Carcinomes Basocellulaires (Cbc) Du Borunclassified

“…Là aussi, l'utilisation d'un examen extemporané des bords dans les carcinomes épidermoïdes limite la fréquence des récidives dans les grandes séries [4]. Toutefois, en cas de lésions multifocales, c'est-à-dire lorsque la progression tumorale est non contiguë (skip areas), l'intérêt de l'examen extemporané sera limité et une exérèse élargie sera nécessaire.…”

Section: Marges D'exérèse Des Autres Tumeurs Malignes Du Bord Libre Dunclassified

“…Le but de cet article est de montrer qu'il est possible de diminuer les marges d'exérèse tout en respectant la sécu-rité carcinologique. Pour diminuer les marges d'exérèse, il existe deux solutions : l'examen extemporané, et la chirurgie en deux temps [4][5][6]. En étudiant, à partir d'une série de 481 patients atteints de carcinomes de la tête et du cou, seule l'analyse extemporanée pour les lésions des paupières (bord libre et canthus) avait un intérêt [7].…”

Section: Introductionunclassified

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Quelles marges d’exérèse pour les carcinomes de paupières ?

Mouriaux¹,

Stefan²,

Coffin-Pichonnet³

et al. 2015

Journal Français d'Ophtalmologie

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Section: Marges D'exérèse Des Carcinomes Basocellulaires (Cbc) Du Borunclassified

Section: Marges D'exérèse Des Autres Tumeurs Malignes Du Bord Libre Dunclassified

Section: Introductionunclassified

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Quelles marges d’exérèse pour les carcinomes de paupières ?

Mouriaux¹,

Stefan²,

Coffin-Pichonnet³

et al. 2015

Journal Français d'Ophtalmologie

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“…Postoperative recurrence of primary BCC has been reported at rates of 1.7% in the frozen section group and 1.6% in a Mohs micrographic surgery group. 13,15 Although both of these techniques result in similar recurrence rates, Mohs micrographic surgery is more difficult and costly to perform.16 The aim of the present study was to report the surgical outcomes of patients who presented to our clinic with recurrent periocular BCC after primary excision and underwent frozen section controlled excision to prevent further recurrence.…”

Section: Introductionmentioning

confidence: 98%

The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids

Şahan¹,

Çiftçi²,

Özkan³

et al. 2016

tjo

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Objectives: To show the importance of frozen section-controlled excision to avoid the re-recurrence of recurrent basal cell carcinoma (BCC) of the eyelids.Materials and Methods: Thirty-five cases who underwent eyelid tumor excision in different centers and were admitted to our clinic with recurrent eyelid tumors. Recurrent tumors were resected by excision 1-2 mm from the tumor’s visible margin and sent to pathology for frozen section examination. Eyelid reconstructions with flap and graft were performed after confirming that the surgical margins were negative.Results: Twenty-one (60%) of our patients were male and 14 (40%) were female. Median age of our group was 63.4±14.2 years. Excision and sending the excised material for frozen section control was performed once for 11 patients, twice for 12 patients, 3 times for 8 patients and 4 times for 4 patients to confirm that the surgical margins were clean. All pathology samples were reported as BCC. All patients had eyelid reconstruction with flap and graft. Recurrence was detected in 2 patients (5.7%) during 1 to 8 years (mean 4.3 years) of follow-up and those patients were reoperated; no recurrence was detected in the remaining 33 patients (94.3%).Conclusion: Frozen section control can provide low re-recurrence rate in patients with recurrent BCC of the eyelids.

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“…The indications for 'en face' frozen section were recurrent tumours, tumours located in anatomically sensitive areas, aggressive histological subtypes, perineural invasion or large tumours >2 cm. The 'en face' method is a technique that permits examination of the entire tumour margin (20 …”

Section: Patientsmentioning

confidence: 99%

A reliable frozen section technique for basal cell carcinomas of the head and neck

Menesi¹,

Buchel²,

Hayakawa³

2014

CAN J PLAST SURG

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Basal cell carcinoma (BCC) is the most common skin cancer worldwide and represents 75% of cutaneous malignancies (1). The mortality rate from BCCs is <1% and metastases rarely occur (0.0028% to 0.5%) (2-6). Achieving clear margins, particularly with the more aggressive histological subtypes of BCC and in recurrent tumours, can prove challenging. In these scenarios, the visible clinical margin frequently underestimates the true extent of the tumour. This phenomenon is often referred to as subclinical tumour growth with fingerlike extensions. It is particularly common in the danger zone of the face (H zone), where BCCs often behave more aggressively and recur more frequently (7,8).Before reconstruction, it is imperative that the entire BCC be removed with negative pathological margins. Incomplete resection of primary and recurrent tumours can lead to substantial morbidity and even mortality (9). The majority of BCCs can be treated using standard techniques including conventional surgical excision, curettage, cryotherapy and radiotherapy. The recurrence rates for each of these techniques has been reported to be 3% to 42% following surgical excision (10-12), 3% to 9% with curettage (13,14), 4% to 17% following cryotherapy (10) and 7% to 10% after radiation (15).Mohs micrographic surgery (MMS) or frozen section have been recommended for difficult tumours such as recurrent tumours, tumours located in anatomically sensitive areas, aggressive histological subtypes, perineural invasion or large tumours >2 cm in size (7). Cure rates with MMS has proven better than with other treatment modalities, with low overall five-year recurrence rates of 0.6% to 3% for primary BCC, and 6% to 10% for recurrent . Disadvantages of MMS include the fact that it can be very time consuming, expensive and the reconstruction may be deferred if the Mohs surgeon is not comfortable with more involved reconstructive procedures.We evaluated the effectiveness of a surgeon-directed 'en face' frozen section technique that immediately evaluates the entire peripheral and deep margins during BCC resection and potentially offers a more efficient and equally effective alternative to MMS. METHODS PatientsThe study group comprised 50 patients who were treated by a single plastic surgeon (TH) in a tertiary centre. Fifty-three BCCs were evaluated. All tumours excised from the face over a five-year period (2002 to 2006) were retrospectively reviewed. The indications for 'en face' frozen section were recurrent tumours, tumours located in anatomically sensitive areas, aggressive histological subtypes, perineural invasion or large tumours >2 cm. The 'en face' method is a technique that permits examination of the entire tumour margin (20). The sections for the 'en face' method are cut very thin to enable maximal tissue preservation. Basal cell carcinomas (BCCs) of the head and neck treated by conventional techniques of surgical excision, curettage, cryotherapy and radiation therapy have recurrence rates of up to 42%. Mohs micrographic surgery (MMS) decreases the r...

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Outcomes of Excision of 1750 Eyelid and Periocular Skin Basal Cell and Squamous Cell Carcinomas by Modified En Face Frozen Section Margin-controlled Technique

Cited by 23 publications

References 39 publications

Quelles marges d’exérèse pour les carcinomes de paupières ?

Quelles marges d’exérèse pour les carcinomes de paupières ?

The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids

A reliable frozen section technique for basal cell carcinomas of the head and neck

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