Complete Excision Rate of Periocular Basal Cell Carcinoma in a Teaching Hospital

Elizabeth Conner

Meeting:  2015 RANZCO


Date:      -

Session Title: Oculoplastic/Refractive Surgery/Cataract Rapid Fire

Session Time:      -

Purpose: To review the complete excision rate of Basal Cell Carcinoma (BCC) at Christchurch Public hospital

Method: Retrospective case review of patients diagnosed with BCC on pathological examination over 5 years† (January 2010- December 2014). Cases were identified by the electronic pathology database and their notes reviewed.

In the majority of cases, the primary procedure was done by a registrar with the aim of complete excision and primary closure. After pathological examination, if positive margins were identified (i.e. incomplete excision) further excision was undertaken under the supervision of a consultant ophthalmologist to achieve complete excision.

The data was analysed for risk factors which may increase the likelihood of incomplete excision.

Results: A total of 111 patients were identified. On initial excision 52% of the BCCs were completely excised. Following second excision 88% were free of malignancy.

On review of histology, 58% were infiltrating tumours, 35% were nodular, 5% superficial and 2% were not specified.

Conclusion: The rate of incomplete excision on primary procedure in this study was significantly higher than that reported in current literature where excision is undertaken by sub-specialist consultants. This places increased demands on patient and pathology resources.

However, given the high population demand and constrained resources in managing skin lesions, this approach offers a number of advantages Education of registrars should improve the rate of complete excision thus reducing the demands on resources †and improving patient outcomes.