Staged Excision Technique for Periocular Cutaneous Melanoma: Long-Term Outcomes of the Square Procedure. Ophthalmic Plast Reconstr Surg 2025 Jan-Feb 01;41(1):36-42
Date
07/16/2024Pubmed ID
39012303DOI
10.1097/IOP.0000000000002710Scopus ID
2-s2.0-85199267459 (requires institutional sign-in at Scopus site)Abstract
PURPOSE: To examine the long-term outcome of the staged excision via the square procedure for the treatment of periocular thin cutaneous melanoma.
METHODS: A retrospective chart review of 95 periocular cutaneous melanoma-in-situ and microinvasive melanoma tumors that were treated with the square procedure between April 1, 1994 and December 31, 2018 at the University of Michigan. Demographic and clinical data were evaluated.
RESULTS: Of 95 cases, 19 (20%) were atypical junctional melanocytic proliferation with features of early melanoma-in-situ, 63 (66.3%) were melanoma-in-situ and 13 (13.7) were microinvasive melanoma with Breslow depth less than 1 mm. Tumor-free margins were achieved with a median margin of 10 mm (range 5-40 mm). Most cases (68.4%) required multiple excision stages. Surgical revision was necessary in 17.9% of cases and was associated with larger defect size. Local recurrence was noted in 8 patients (8.4%) at a median of 42 months postreconstruction. No tumor characteristics were found to predict recurrence.
CONCLUSIONS: The square procedure for periocular melanoma offers an 8.4% recurrence rate, consistent with literature reports on similar staged excision approaches. The staged excision provides an excellent option for comprehensive margin review and tumor control with acceptable cosmetic results after reconstruction.
Author List
Mirzania D, Zhao Z, Weber M, Ahdoot R, Juntipwong S, Harms K, Aakalu VK, Kim DS, Demirci H, Nelson CCAuthor
Vinay Kumar Aakalu MPH, MD Chair, Professor in the Ophthalmology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Eyelid Neoplasms
Female
Follow-Up Studies
Humans
Male
Margins of Excision
Melanoma
Middle Aged
Neoplasm Recurrence, Local
Ophthalmologic Surgical Procedures
Retrospective Studies
Skin Neoplasms
Treatment Outcome
