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Long-term follow-up of invasive ocular surface squamous cell carcinoma treated with excision, cryotherapy, and topical mitomycin C

  • Oncology
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Abstract

Background

To evaluate the efficacy of surgical excision, cryotherapy and topical Mitomycin C (MMC) for ocular surface squamous cell carcinoma (SCC) with at least 24 months follow-up.

Methods

Seventeen patients with primary and recurrent invasive SCC of ocular surface underwent surgical excision and map biopsy of the margins, and double freeze-thaw cryotherapy of the bed and margins. Topical MMC (0.04%, 4 times daily) was commenced 7–10 days after operation. It was delivered in cycles that consisted of medication 4 times daily for 7 consecutive days followed by 7 consecutive days of no medication. Patients with primary SCC received two cycles (protocol 1) and those with recurrent SCC received three cycles (protocol 2). Patients with intra-ocular and or orbital extension or those with less than 24 months of follow-up were excluded. The frequency of tumor recurrence and complications associated with treatment were measured.

Results

Mean age was 70.7 years (SD = 10, range: 48–80). Mean follow-up time was 48 months (SD = 21, range: 24–89). There were 12 patients with primary SCC and five with recurrent SCC. Mean largest diameter was 9.7 mm (3–20). Surgical margins were free in 12 cases. One patient with recurrent SCC who received protocol 2 treatment developed recurrence 9 months after excision, and remained free of recurrence 24 months after second treatment. Complications comprised transient mild punctate corneal epithelial erosion (eight), irritation and conjunctival hyperemia (11), corneal scar (six), and scleral thinning (three). All except one responded well to conservative management. One scleral thinning required scleral patch graft 1 year after treatment.

Conclusion

The combination of surgical excision, cryotherapy, and post-operative topical mitomycin-C was effective treatment for ocular surface invasive SCC in long-term follow-up.

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Acknowledgment

This study was financially supported by Tehran University Eye Research Center, Tehran, Iran.

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Authors and Affiliations

  1. Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Sattarkhan-Niayesh Street, Tehran, 14455-364, Iran

    Mohsen Bahmani Kashkouli, Abtin Heirati, Farzad Pakdel, Victoria Kiavash, Masood Naseripour & Farzaneh Aghamohammadi

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  1. Mohsen Bahmani Kashkouli
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  2. Abtin Heirati
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  3. Farzad Pakdel
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  4. Victoria Kiavash
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  5. Masood Naseripour
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  6. Farzaneh Aghamohammadi
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Correspondence to Mohsen Bahmani Kashkouli.

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Authors have no financial relationship with the manufacturer of any product discussed in this manuscript.

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Kashkouli, M.B., Heirati, A., Pakdel, F. et al. Long-term follow-up of invasive ocular surface squamous cell carcinoma treated with excision, cryotherapy, and topical mitomycin C. Graefes Arch Clin Exp Ophthalmol 250, 1527–1532 (2012). https://doi.org/10.1007/s00417-012-1931-x

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  • DOI: https://doi.org/10.1007/s00417-012-1931-x

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