Risk Factors for Orbital Exenteration in Periocular Basal Cell Carcinoma

Iuliano, Adriana; Strianese, Diego; Uccello, Giovanni; Diplomatico, Agostino; Tebaldi, Sabrina; Bonavolontà, Giulio

doi:10.1016/j.ajo.2011.08.004

Cited by 49 publications

(39 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Group 2 included cases with histological diagnoses of non-BCC. The rationale behind this grouping was based on the fact that BCCs are considered to be less aggressive neoplasms 13. This assumption was further confirmed with a Kaplan–Meier survival analysis, as shown in figure 2.…”

Section: Resultsmentioning

confidence: 75%

Life expectancy following orbital exenteration

2014

View full text Add to dashboard Cite

Orbital exenteration is a physically debilitating procedure that may be a necessity in the management of orbital malignancy. It requires a sensitive multidisciplinary approach, both preoperatively and postoperatively. Providing life expectancy information for patients during preoperative counselling is pertinent to informed consent and in addressing patients' expectations. A retrospective review from one tertiary care centre was undertaken for a cohort of patients who were exenterated for orbital malignancy between 1998 and 2010. The cases were identified using an International Classification of Diseases 10th Revision (ICD-10)-derived database and were analysed using Prism statistical software (V.5.04). Cause of death was ascertained by liaising with the general practitioner and the National Registrar Office for Births, Deaths, and Marriages, Southport, UK. In total, 41 men and 32 women were identified. Mean age was 72 years with 47 cases living and 26 deceased at the time of review. The overall 5-year survival rate in this study was 64%. Kaplan-Meier analysis for basal cell carcinoma (BCC) against non-BCC returned a p value of 0.0199, with an HR of 0.3927 (CI 0.1788 to 0.8626). Kaplan-Meier analysis for cleared against non-cleared margins returned a p value of 0.2890, with an HR of 0.6571(CI 0.3024 to 1.428). Our results represent the highest 5-year survival data to date. However, the overall prognosis for patients who undergo orbital exenteration for malignancy remains poor. We hypothesise that the causes are multi-factorial. We recommend a multidisciplinary approach to the care of these patients, involving head and neck teams, oncology and other appropriate specialties, to optimise outcomes for this vulnerable patient group.

show abstract

Section: Resultsmentioning

confidence: 75%

Life expectancy following orbital exenteration

2014

View full text Add to dashboard Cite

show abstract

“…It may be combined with adjunctive radiotherapy when margins are not clear or in high-risk aggressive tumors with perineural invasion 6. When the lesion involves a medial canthal location, margin-controlled excision does not need to be performed at initial treatment, but when pathological analysis shows an infiltrative subtype, exenteration is strongly recommended 28. Madge et al described a case series of 20 patients with anterior orbital invasion by medial canthal BCC treated with non-exenterating surgery.…”

Section: Treatment Of Periocular Bccmentioning

confidence: 99%

Ocular basal cell carcinoma: a brief literature review of clinical diagnosis and treatment

Shi

Jia

2017

OTT

View full text Add to dashboard Cite

Basal cell carcinoma (BCC) is a common malignant tumor throughout the world. One of the known risk factors of BCC is intense exposure to ultraviolet radiation. More than 50% of BCCs of the eyelid initially occur on the lower lid. The gold standard of diagnosis of BCC is histopathology. Treatment options for BCC consist of surgery, vismodegib, radiotherapy and imiquimod. Surgical excision using Mohs micrographic surgery or wide surgical excision with frozen section margin control is the first consideration for treatment of periocular BCC. Eyelid reconstruction should be carefully considered as both function and esthetic outcome in patients are important after clear excision of tumors. Exenteration is considered in the case of extensive orbital invasion or high-risk aggressive tumors in order to reduce the rate of recurrence.

show abstract

“…Orbital exenteration, although disfiguring and blinding, is often the only option for cure when incompletely excised medial canthal tumors extend into the orbit. 2 The Food and Drug Administration has recently approved a hedgehog pathway inhibitor 3 with an adequate safety profile, 4 Vismodegib (Erivedge, Genentech, CA), for oral treatment of basal cell nevus syndrome 5 and locally advanced or metastatic BCCA. 6 We report a patient with BCCA invading the medial orbit who was treated with oral vismodegib, resulting in near-total tumor shrinkage that permitted complete excision with clear surgical margins.…”

mentioning

confidence: 99%

Vismodegib as Eye-Sparing Adjuvant Treatment for Orbital Basal Cell Carcinoma

2013

View full text Add to dashboard Cite

If these lesions were at the level of the RPE, one would expect them to be visualized on FAF imaging. However, they were completely silent on FAF imaging, suggesting that they may be located deeper than the RPE, at the level of the choriocapillaris. We distinguished 3 types of lesions based on their multimodal imaging characteristics in APMPPE. Type 1 lesions seem to be located at the level of the choriocapillaris and are transient. Type 2 and 3 lesions are at the level of the RPE and are permanent.The pigmented lesions were distributed along the choroidal vasculature on AO imaging (Figure 2). They may correspond to pigment-laden macrophages or accumulation of pigment granules and may indicate a secondary reaction at the level of the RPE induced by an inflammatory process at the level of the choroidal vasculature. Their size and shape were not consistent with RPE cells.Acute posterior multifocal placoid pigment epitheliopathy is characterized by prominent RPE changes, but the permanent RPE damage (type 2 and 3 lesions) may be secondary to an acute transient choroidal inflammatory process (type 1 lesions).

show abstract

Risk Factors for Orbital Exenteration in Periocular Basal Cell Carcinoma

Cited by 49 publications

References 20 publications

Life expectancy following orbital exenteration

Life expectancy following orbital exenteration

Ocular basal cell carcinoma: a brief literature review of clinical diagnosis and treatment

Vismodegib as Eye-Sparing Adjuvant Treatment for Orbital Basal Cell Carcinoma

Contact Info

Product

Resources

About