Abstract
Purpose: :
To identify predictors of ocular surface squamous neoplasm (OSSN) recurrence after surgical resection.
Methods: :
Review of pathology records and patient charts of 389 consecutive OSSN lesions excised at the Bascom Palmer Eye Institute from January 1, 2001, to September 20, 2010
Results: :
Of 389 completely excised OSSN lesions, forty-four (11%) recurred during follow up. The 1 year recurrence rate was 10% and the 5 year recurrence rate was 21%with a mean time to recurrence in those with a recurrence of 2.5 years (SD 3.4). Location characteristics that increased the risk of tumor recurrence were tarsal involvement (HR=4.12, p = 0.007). Nasal locations were associated with a decreased risk of tumor recurrence (HR=0.41, p=0.008). Pathologic characteristics significantly associated with tumor recurrence were the presence of positive margins (HR=2.73, p= 0.008). Treatment with adjuvant cryotherapy significantly decreased the risk of tumor recurrence (HR=0.51, p=0.03). In those patients with positive margins, the use of post-operative topical interferon therapy lowered the recurrence rate to a level similar to that of patients with negative margins.
Conclusions: :
Certain patient and tumor factors are associated with a higher risk of OSSN recurrence after surgical excision. Post-operative adjuvant therapy should be considered in patients with high risk OSSN characteristics, including tarsal tumor location and positive surgical margins.
Keywords: tumors • conjunctiva • cornea: epithelium