Predictors of recurrence of basal cell carcinoma of the eyelids and the periocular region

Background and objectives. Basal cell carcinoma is the most common malignant tumour of the eyelids but surgical excision in the eyelid region is often in conflict with preserving lid function. The purpose of this study was to identify factors predictive of basal cell carcinoma recurrence to improve pre- and postoperative planning. Patients and methods. A total of 153 patients with basal cell carcinomas without recurrence of at least 5 years were compared with 45 primary lesions of recurrent basal cell carcinomas. Using bivariate correlations and multiple regression analysis, clinical factors were analysed for their value to predict recurrence. Results. Incompletely excised tumours were most likely to recur and re-excised tumours had a higher recurrence rate than primary completely excised tumours. Morphea or sclerosing lesions had a significantly higher tendency to recur than nodular lesions. The recurrency rate decreased with the tumours distance from the lid margin. Based on these facto rs the calculated risk of a patient was between 47% and 63% with an estimated risk of recurrence of 50%. Conclusions. Predicting recurrence using these factors, is not possible in a clinically relevant dimension. So all patients with a basal cell carcinoma of the eyelids or periocular region must be re-examined regularly to detect recurrent lesions as early as possible. Of all recurrences, 89% occurred within the first 5 postoperative years, therefore this should be regarded as the minimal sufficient follow-up time.