Levin Flora, Khalil Monica, McCormick Steven A, Della Rocca David, Maher Elizabeth, Della Rocca Robert C
Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA.
Arch Ophthalmol. 2009 Aug;127(8):1011-5. doi: 10.1001/archophthalmol.2009.222.
To report our experience with 200 cases of basal cell carcinoma (BCC) in 192 patients treated with an enhanced frozen-section control (FSC) technique using stereoscopic microdissection of surgical margins.
Retrospective series of 192 patients with 200 lesions diagnosed as BCC of the periocular region. All were excised en bloc with 1-mm margins beyond the clinically apparent tumor and examined using an enhanced FSC technique with stereoscopic microdissection of the surgical margins.
Of 200 malignant BCCs, 93.0% represented primary tumors. The overall recurrence rate was 1.0%, with a mean follow-up of 4 years. In patients with primary lesions, the overall recurrence rate was 1.1%, with a mean follow-up of 3.9 years. There were no recurrences in the secondary tumor group after a mean follow-up of 4.8 years. Of the 200 lesions, 66.0% lesions required a single en bloc resection to achieve tumor-free margins.
An enhanced FSC technique using stereoscopic microdissection of the surgical margins permits greater conservation of healthy tissue and yields cure rates comparable to those of the standard FSC technique and Mohs micrographic surgery. We believe that this enhanced FSC technique is a highly effective method for resection of periocular BCC.
报告我们对192例患者共200例基底细胞癌（BCC）采用增强型冰冻切片对照（FSC）技术（利用手术切缘的立体显微切割）进行治疗的经验。
对192例患者共200个病变进行回顾性研究，这些病变均被诊断为眼周区域的基底细胞癌。所有病变均整块切除，切除范围超出临床可见肿瘤边缘1毫米，并采用增强型FSC技术对手术切缘进行立体显微切割检查。
在200例恶性基底细胞癌中，93.0%为原发性肿瘤。总体复发率为1.0%，平均随访4年。原发性病变患者的总体复发率为1.1%，平均随访3.9年。继发性肿瘤组平均随访4.8年后无复发。在200个病变中，66.0%的病变需要单次整块切除以获得无瘤切缘。
采用手术切缘立体显微切割的增强型FSC技术能够更大程度地保留健康组织，其治愈率与标准FSC技术和莫氏显微外科手术相当。我们认为这种增强型FSC技术是切除眼周基底细胞癌的一种高效方法。
