Carter K D, Nerad J A, Whitaker D C
Department of Ophthalmology, University of Iowa College of Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242-1091, USA.
Ophthalmic Plast Reconstr Surg. 1999 Mar;15(2):83-91. doi: 10.1097/00002341-199903000-00004.
To determine if the surgical defect after excision of periocular skin cancers can be predicted preoperatively.
Review of medical records of patients who underwent excision of periocular skin cancers between 1990 and 1995.
Two hundred sixty-four patients (157 men, 107 women) with a total of 281 malignant tumors were treated. Basal cell carcinoma accounted for 92.2% of the tumors, whereas squamous cell carcinoma constituted 6.4% of lesions. The lower eyelid and medial canthus were the most frequent sites of involvement. Data analysis was conducted on tumor size, cell type, location, and the Mohs stages and sections that were required for cure. Morpheaform basal cell carcinomas required the most Mohs stages and sections and resulted in the largest excisional defects when compared with clinical tumor dimensions. The lateral canthus had the fewest tumors, but lesions in this area resulted in the largest excisional defects (mean, 9.5 cm2) when compared with lesions of the medial eyelid (p = 0.35). The average size of the defect after Mohs excision of basal cell carcinoma was 4.2 to 4.6 times the original clinical tumor size. For morpheaform basal cell carcinoma, however, the average excisional defect was 6.1 times larger. Conversely, the average defect after excision of squamous cell carcinoma was only 2.6 times as large as the original clinical tumor size.
These data are useful in predicting the size of a defect after Mohs excision of periocular skin cancer, based on the original clinical tumor size.
确定眼周皮肤癌切除术后的手术缺损是否能够在术前进行预测。
回顾1990年至1995年间接受眼周皮肤癌切除术患者的病历。
共治疗了264例患者（157例男性，107例女性），总计281个恶性肿瘤。基底细胞癌占肿瘤的92.2%，而鳞状细胞癌占病变的6.4%。下眼睑和内眦是最常受累的部位。对肿瘤大小、细胞类型、位置以及治愈所需的莫氏分期和切片进行了数据分析。与临床肿瘤尺寸相比，硬斑病样基底细胞癌需要最多的莫氏分期和切片，并且导致最大的切除缺损。外眦的肿瘤最少，但与内眼睑病变相比，该区域的病变导致最大的切除缺损（平均9.5平方厘米）（p = 0.35）。基底细胞癌莫氏切除术后缺损的平均大小是原始临床肿瘤大小的4.2至4.6倍。然而，对于硬斑病样基底细胞癌，平均切除缺损大6.1倍。相反，鳞状细胞癌切除术后的平均缺损仅为原始临床肿瘤大小的2.6倍。
这些数据有助于根据原始临床肿瘤大小预测眼周皮肤癌莫氏切除术后缺损的大小。
