If patients are clinically selected for conventional tumour surgery rather than MMS then it is crucial to ascertain that their outcomes remain optimal. This helps validate the treatment itself but also the selection criteria. This study prospectively evaluated all patients selected for conventional surgery.

All patients presenting to a multidisciplinary periocular tumour clinic between January 2004 and January 2014 who were selected for conventional surgery were prospectively evaluated. Recorded data included tumor site; size; clinical and histological margins; histology; recurrence; functional outcomes and final cosmesis: the latter scored by a predetermined scheme.

In total 251 tumors were excised from 234 patients; mainly from lower lids (52.6%), followed by medial canthus (13.1%). Clinical size measured 2-25 mm (mean 7.7 mm). Histological type was 91.2% nodular; 5.9% superficial and 2.5% morpheiform.
The mean surgical excision margin was 3.3 mm (range 1-5 mm) while the mean histopathological excision margin was 2.2 mm (0.1-5.5 mm). No BCC was incompletely excised. Mean follow-up was 42 months ( 60% patients were followed-up >3 years and 27.5% >5 years). 27 patients died during follow up. No tumour recurred within 5 y however 1 recurred at 68 months (0.4%). Cosmetic and functional outcomes were good or excellent in 91.7%.

When clinical selection criteria are applied in the setting of a multidisciplinary clinic, conventional surgery for periocular BCC appears safe.